3"^  UBRARIES   Zk 

RXAUTIl 
MSRAXY 


I 

BOOKS 

BV 

ANNAM.GALBRAITH,M.D. 


Fout  Epochs  of  Woman^s  Life 
i2mo  of  247  pages,  illustrated. 
Cloth,  ^1.50  net.  2d  Edition 


Pefsonal  Hygiene  and  Physical 

Training  for  Women 

i2mo  of  371  pages,  illustrated. 

Cloth,  $2.00  net. 


PERSONAL    HYGIENE 


AND 


PHYSICAL  TRAINING 
FOR  WOMEN 


BY 

ANNA  M.  GALBRAITH,   M.D. 

Author  of  "  Hygiene  and  Physical  Culture  for  Women  "  and  "  The  Four 
Epochs  of  Woman's  Life  ;  "  Member  of  the  New  York  County  and  State  and 
the  American  Medical- Associations  ;  Fellow  of  the  New  York  Academy  of 
Medicine  ;  Ex-President  of  the  Alumnae  Association,  Woman's  Medical  College 
of  Pennsylvania ;  former  Attending  Physician,  Neurological  Department,  of 
the  New  York  Orthopoedic  Hospital  and  Dispensary;  late  Attending  Physician 
and  Instructor  in  Diagnosis  and  Clinical  Medicine  at  the  Woman's  Medical 
College,  New  York  Infirmary 


ILLUSTRATED 


PHILADELPHIA  AND  LONDON 

W»    B.    SAUNDERS    COMPANY 

19  13 


G-13 


Copyright,  1911,  by  W.  B.  Saunders  Company 


Reprinted  April,  1913 


PRINTED    IN    AMERICA 

PRESS    OF 

W.     B.     SAUNDERS     COMPANV 

PHILADELPHIA 


In  Loving  Memory 

of 

HELEN  WORTHING  WEBSTER,  M.D. 

Professor  of  Physiology  and  Hygiene  and  Resident  Physician  at  Vassar  College 
from  1874  to  1881 

An  untiring  worker  of  charming  and  inspiring  personality 
the  living  embodiment  of  all  that  was  womanly, 
great  hearted,  and  noble 
This  book  is  affectionately  dedicated  as  a  slight  tribute  of 
the  esteem  in  which  she  was  held,  and  in  grateful  acknowl- 
edgment of  the  value  of  her  teachings 
By  her  former  pupil 
THE  AUTHOR 


Digitized  by  tine  Internet  Arciiive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/personalhygienepOOgalb 


PREFACE 


The  aim  of  this  work  has  been  to  present  in  a  clear 
and  concise  manner  the  fundamental  physiological  laws 
on  which  aU  personal  hygiene  is  based ;  together  with  the 
practical,  detailed  directions  for  the  proper  development 
of  the  body  and  the  training  of  the  physical  powers  to 
their  highest  degree  of  efficiency  by  means  of  fresh  air, 
tonic  baths,  proper  food  and  clothing,  gymnastic  and  out- 
door exercise,  so  that  the  tissues  will  be  placed  in  the 
best  possible  condition  to  resist  disease. 

The  spirit  of  the  times  demands  nothing  less  than  the 
most  perfect  development  of  body  and  mind  of  which 
youth  is  capable,  and  maintaining  the  highest  degree  of 
efficiency  of  the  adult  worker  for  the  longest  possible  term 
of  years.  The  fiat  has  gone  forth  from  the  American 
Medical  Association  for  the  scientific  education  of  the 
pubhc  in  the  laws  of  hygiene  and  sanitation.  And  the 
great  civic  movement  inaugurated  by  that  same  Associa- 
tion and  the  Committee  of  One  Hundred  on  National 
Health  for  the  establishment  of  a  National  Department 
of  Public  Health,  promises  to  be  crowned  with  success  in 
the  near  future.  And  so  it  has  been  deemed  superfluous 
to  expound  at  length  what  preventive  medicine  has  al- 
ready accomplished  in  the  short  space  of  fifty  years  by 
the  eradication  of  terrible  epidemics  and  many  diseases, 

5 


6  PREFACE 

and  what  a  general  knowledge  of  applied  hygiene  might 
reasonably  be  expected  to  accomplish  in  the  near  future. 
It  gives  the  author  great  pleasure  to  have  this  oppor- 
tunity of  expressing  her  deep  indebtedness  to  Miss  Ruth 
Blankenhorn,  Vassar  College,  A.  B.,  1909,  of  Englewood, 
N.  J.,  a  most  artistic  and  graceful  dancer  who  posed  for 
all  the  illustrations;  and  to  Miss  Harriet  I.  Ballintine,  the 
able  director  of  the  Vassar  College  Gymnasium,  who  ar- 
ranged the  poses  for  the  very  excellent  plates  illustrating 
the  free  exercises  and  classic  dances.  Also  to  the  Vassar 
College  Athletic  Association  for  1908-09  for  the  especially 
arranged  dances  and  field  sports  which  they  were  so  ex- 
tremely kind  as  to  demonstrate  for  her  benefit. 

Anna  M.  Galbraith. 
New  York  City. 


CONTENTS 


CHAPTER  I 

PAGE 

Hydrotherapy 11 

Description  of  the  Skin;  Functions  of  the  Skin,  the  Physio- 
logic Effects  of  Water,  Hot  and  Cold;  the  Chief  Varieties  of 
Baths;  Ablutions;  the  Tub  Bath;  the  Alcohol  Rub;  the 
Cold  Dip;  AlkaUne  and  Saline  Baths;  the  Rain  Douche  or 
Shower  Bath;  the  Hot  Foot-bath;  the  Sitz  Bath;  Technic  of 
the  Wet  Sheet;  Wet  Hand  Rub;  the  Salt  Glow;  Salt  Ablu- 
tion; the  Turkish  Bath;  the  Electric-light  Bath;  Indica- 
tions for  the  Use  of  Turkish  Bath,  and  Contraindications; 
the  Douche;  the  Percussion  Douche;  Application  of  the 
Douche;  Rationale  of  the  Douche;  Contraindications. 

The  Internal  Use  of  Water;  Its  Action  on  the  Heart  and 
Blood,  on  the  Digestion;  Therapeutic  Indications  for  the 
Use  of  Water;  Contraindications  for  Drinking  Cold  Water; 
The  French  Cures  of  the  Vosges. 

Enemas;  Vaginal  Douche;  Douching  the  Ear. 

CHAPTER  II 

The  Care  of  the  Skin  and  its  Appendages 53 

The  Complexion;  the  Action  of  the  Bath  in  Health;  the 
Proper  Time  to  Bathe;  the  Care  of  Wash-cloths;  Cleansing 
the  Face;  Protection  of  the  Face;  the  Use  of  So-called  Cos- 
metics for  the  Face;  Facial  Blemishes,  Freckles,  Liver  Spots, 
Sallow  Complexion,  Pimples,  Acne,  Eczema,  Wrinkles,  and 
Superfluovis  Hair  and  Their  Treatment;  the  Relation  of  Dis- 
eases of  the  Skin  to  Internal  Disorders. 

The  Hair;  Dandruff;  Causes  and  Treatment  of  Premature 
Thinness  of  the  Hair  and  Baldness;  the  Care  of  the  Hair; 
Gray  Hair. 

The  Cosmetic  Care  and  Treatment  of  the  Hands;  Cos- 
metic of  the  Nails;  the  Care  of  the  Feet;  Painful  Affections  of 
the  Feet. 

CHAPTER  III 
The  Digestive  System  and  the  Maintenance  of  Good  Diges- 


The  Digestive  Tract;  the  Care  of  the  Mouth  and  Teeth; 
Digestion  a  Chemical  Process;  Digestion  in  the  Small  In- 
testine; the  Microorganisms  of  the  Alimentary  Canal;  the 

7 


80 


8  CONTENTS 

PAGE 

The  Digestive  System  and  the  Maintenance  of  Good  Diges- 
tion (Continued) 

Importance  of  a  Varied  Diet;  Classification  of  Food-stuffs; 
Tea,  Coffee,  and  Cocoa;  the  Temperature  of  Foods  and 
Drinks;  Factors  which.  Favor  Good  Digestion. 

Overeating;  Dietary  in  Sedentary  Occupations;  Heart 
Failure  and  Other  Ills  as  the  Result  of  Chronic  Under- 
feeding; the  Causes  of  Indigestion;  the  Symptoms  of  Indi- 
gestion; Intestinal  Indigestion;  Biliousness  and  Bilious 
Attacks;  Ptomain  Poisoning;  Diet  in  Indigestion;  Treat- 
ment of  Acute  Diarrhea;  Chronic  Intestinal  Catarrh;  Consti- 
pation and  Mental  Troubles;  Treatment  of  Constipation. 

The  Physiologic  Action  of  Moderate  Doses  of  Alcohol; 
the  Effect"^of  Alcohol  on  the  Muscular  System;  the  Effect 
of  Alcohol  on  the  Nervous  System. 

CHAPTER  IV 

The  Respiratoet  and  Circulatory  Systems:  the  Kidneys.  .  125 
The  Mechanics  of  Circulation  and  Respiration;  the 
Circulatory  Apparatus;  the  Lungs;  Hygiene  of  the  Lungs 
and  Its  Relation  to  the  General  Health;  Relation  of  Res- 
piration to  Body  Heat;  the  Respiratory  Fimctions  of  the 
Abdominal  Miiscles;  the  Importance  of  Good  Chest  Develop- 
ment, Proper  Relation  Between  the  Height,  Weight,  and 
Chest  Measurements;  Chemical  Properties  of  Air;  To\v-n 
and  Coimtry  Air;  Dust  and  Its  Relations  to  Disease;  Role 
Played  by  Bacteria;  Ventilation;  the  Injurious  Effects  of 
Overheated  Air;  the  Proper  Degree  of  Moisture  for  the 
Air  of  the  House;  Ventilation  of  Bed-rooms. 

Care  of  the  Nose,  Throat,  and  Ears;  Impediments  to 
Respiration;  Ventilation  of  the  Lungs  and  Breathing  Ex- 
ercises; Cure  of  Chronic  Bronchitis  by  Deep  Breathing  Ex- 
ercises; Relation  of  Colds  to  Pneumonia  and  Tuberculosis, 
and  Their  Prevention. 

The  Kidneys  and  Their  Functions;  the  Physiology  of 
the  Female  Pelvic  Organs. 

CHAPTER  V 

The  Nervous  System  as  the  Balance  of  Power  in  the 
Body 172 

The  Brain  the  Master  Organ  of  the  Body;  the  Functions 
of  the  Brain;  Habit  and  Automatism;  the  Physiology  of  the 
Brain  and  Nervous  System;  the  Hygiene  of  Work;  the  Tox- 
ins of  Fatigue;  Overwork;  Signs  of  Ovem-ork;  Nature's  Res- 
toratives; Avocation;  and  Physiologic  Necessity  for  Laugh- 
ter; Vacations  and  Health;  Sleep;  Insomnia. 

The  Eyes;  Eye-strain;  Description  of  the  Visual  Appa- 
ratus; Optical  Defects  and  Their  Correction;  the  Mechan- 
ism of  Eye-strain;  Local  Symptoms  of  Eye-strain;  Arti- 


CONTENTS  9 

PAGE 

ficial  Lighting;  Hygienic  Precautions  in  Reading  and  Sew- 
ing; Injuries  to  the  Eyes;  Symptoms  and  Treatment  of 
Conjunctivitis;  Trachoma;  Styes. 
Functional  Nervous  Disorders;  Headache;  Neurasthenia. 

CHAPTER   VI 

The  Hygiene  of  the  Mind  and  its  Relation  to  the  Physical 

Health 212 

Heredity;  Temperament;  Social  Instincts;  Fear. 

Mental  Development;  Self-control,  the  Moral  Sense,  the 
Rehgious  Instincts;  the  Advantages  of  CoUege  Life;  Bal- 
ance of  the  Mental  Faculties;  the  Effects  of  the  Higher  Ed- 
ucation of  Women. 

The  Environment;  the  Choice  of  Friends;  Literature. 

The  Power  of  the  Will  or  Inhibition;  the  Effect  of  the 
Mental  Attitude  on  the  Physical  Health;  A  Definite  Occu- 
pation a  Physical  Necessity;  the  Psychology  of  Success. 

CHAPTER   VII 

Dress  the  Fundamental    Cause    of    Woman's    Physical 

Deterioration 240 

The  History  of  Woman's  Dress;  the  Corset  in  History; 
the  Crusade  Against  the  Corset;  the  Influence  of  the  Corset 
on  the  Female  Body;  the  Curved  Front  Corset;  the  Relation 
of  Corsets  to  Abdominal  and  Pelvic  Disorders;  the  Effects 
of  Corsets  on  the  Muscles;  the  Straight  Front  Corset;  the 
Abdominal  Corset;  the  Wearing  of  Corsets  by  Young  Girls; 
What  Style  of  Corset  is  the  Least  Injurious;  the  Shoe;  the 
Stockings;  the  Essential  Qualities  for  Winter  Underclothing; 
the  LeE^h  of  the  Walking  Skirt;  the  Winter  Street  Dress. 

CHAPTER  VIII 

Physical  Training  the  Key  to  Health  and  Beauty 271 

The  Ancient  Greeks  the  Most  Perfect  Type  of  Beauty; 
the  Cause  of  the  Inferior  Physique  of  American  Women;  the 
Physical  Training  of  the  Japanese  Women;  Improved 
Physique  as  the  Result  of  Physical  Training;  Increasing 
Stature  and  Improved  Physique  of  American  Men;  Report 
of  the  Royal  Commission  of  Great  Britain  on  Physical 
Training;  Physical  Training  Among  the  Ancients;  the 
Influence  of  Physical  Training  on  the  Health  and  Life  of 
the  Individual;  the  Effect  of  Exercise  on  Bram  Develop- 
ment and  Character;  the  Physiology  and  Pathology  of 
Exercise;  the  Relative  Proportions  of  a  Perfect  Female 
Form;  Table  of  Standard  Weights  for  Women;  the  Muscu- 
lar System;  the  Benefits  of  Exercise;  Passive  Exercise;  Mas- 
sage; the  Balance  and  Carriage  of  the  Body;  Common 


10  CONTENTS 

FAGB 

Physical  Training  the  Key  to  Health  and  BEAtrrY  (Con- 
tinued) 

Defects  in  the  Carriage  of  the  Body;  the  Heart's  Need  of 
Exercise;  the  Gymnasium  in  the  Campaign  Against  Dis- 
ease; Gymnastic  versus  Athletic  Training;  Exercise  After 
Eating;  Effect  of  Brain  Fatigue  on  Body  Fatigue,  and 
vice  versa;  Marks  for  Physical  Efficiency;  Advantages 
Derived  from  Athletic  Sports;  Ethical  Value  of  Sports  for 
Women;  Forms  of  Athletic  Games  Best  Suited  to  Women. 

CHAPTER  IX 

Symmetric  Development:  Good  Carriage  and  Grace  of 

Motion  Through  GYansTASTics  and  Athletics 311 

Gymnasiums,  Baths,  and  Athletic  Associations:  a  Fun- 
damental Part  of  a  Woman's  College  and  a  Model  Woman's 
Club;  the  Vassar  College  Gymnasium;  the  New  York 
Colony  Club;  the  Yoimg  Women's  Christian  Association; 
Self-made  Good  Physique  through  Physical  Training  Rules 
for  Taking  Exercise;  Gymnastic  Dress;  the  Configuration  of 
the  Foot;  Correct  Attitude  in  Standing. 

Corrective  Exercises:  Exercises  for  Developing  the 
Various  Regions  of  the  Body;  Shoulder-blade  Exercises; 
Respiratory  Exercises;  Exercise  for  Forward  Projection  of 
Chest  and  Retraction  of  Abdomen;  Shoulder  and  Back 
Exercises;  Leg  Exercises;  Squatting  Exercises  for  Muscles 
of  Spine  and  Abdomen;  Alternate  Ivneefing;  Abdominal 
Exercises;  Balancing  Exercises  for  Poise  and  Carriage; 
Balancing  Exercises  for  Extending  Depth  of  Chest;  Lateral 
Trunk  and  Waist  Exercises;  Exercises  for  Muscles  of 
Back;  Exercises  for  Muscles  of  Abdomen;  Swimming  Exer- 
cises, for  Back,  Thighs,  and  Abdomen;  Rope-pulling  Exer- 
cises for  Back,  Chest,  Waist,  Legs,  and  Arms;  Exercises  in 
Trunk  Flexions  for  Back,  Abdomen,  and  Legs;  Exercises 
with  Chest  Weights  for  Chest,  Shoulders,  and  Arms;  Box- 
ing and  Fencing;  Classic  and  Jilsthetic  Dancing  an  Essen- 
tial Feature  in  Physical  Training. 

Outdoor  Exercises:  Effect  of  Walking  on  the  Heart  and 
Lungs;  Rmming;  Mountain  Climbing;  Swimming;  Horse- 
back Riding  as  an  Exercise;  Rowing. 

Athletic  Sports:  Croquet;  Lawn-tennis;  Golf;  Hockey; 
Basket-ball. 


Index 353 


PERSONAL   HYGIENE 

AND 

PHYSICAL  TRAINING  FOR  WOMEN 


CHAPTER  I 

HYDROTHERAPY 

Description  of  the  Skin;  Functions  of  the  Skin;  the  Physiologic 
Effects  of  Water,  Hot  and  Cold;  the  Chief  Varieties  of  Baths;  Ablu- 
tions; the  Tub  Bath;  the  Alcohol  Rub;  the  Cold  Dip;  Alkaline  and 
Saline  Baths;  the  Raia  Douche  or  Shower  Bath;  the  Hot  Foot-bath; 
the  Sitz  Bath;  Technic  of  the  Wet  Sheet;  Wet  Hand  Rub;  the  Salt 
Glow;  Salt  Ablution;  the  Turkish  Bath;  the  Electric-light  Bath; 
Indications  for  the  Use  of  Turkish  Bath,  and  Contraindications; 
the  Douche;  the  Percussion  Douche;  Application  of  the  Douche; 
Rationale  of  the  Douche;  Contraindications. 

The  Internal  Use  of  Water;  Its  Action  on  the  Heart  and  Blood, 
on  the  Digestion;  Therapeutic  Indications  for  the  Use  of  Water; 
Contraindications  for  Drinking  Cold  Water;  the  French  Cures  of 
the  Vosges. 

Enemas;  Vaginal  Douche;  Douching  the  Ear. 

The  term  hydrotherapy  will  be  used  here  in  its  broadest 
sense,  and  may  be  defined  as  the  hygienic  and  systematic 
use  of  water,  both  externally  and  internally,  for  the  preser- 
vation and  restoration  of  health  and  the  prevention  of 
disease. 

The  hygienic  and  therapeutic  value  of  the  systematic 
use  of  water  is  just  beginning  to  be  appreciated  by  the 
medical  profession.  When  this  newly  acquired  knowledge 
is  put  to  practical  use  by  the  great  masses  of  the  people, 
there  will  be  a  greatly  diminished  necessity  for  the  use  of 
drugs.     Indeed,  water  has  been  pronounced  by  a  high 

11 


12 


PERSONAL  HYGIENE   FOR  WOMEN 


medical  authority  to  be,  and  probably  is,  more  nearly  a 
panacea  for  all  human  ills  than  any  other  known  agent. 

The  bath  is  generally  considered  merely  as  a  cleansing 
procedure,  whereas  this  is  only  one  of  its  beneficial  effects. 
There  is,  in  addition,  the  stimulation  of  all  the  functions 
and  organs  of  the  body  obtained  through  the  temperature 
of  the  water,  and  the  mechanical  stimulation  which  is 
obtained  by  the  mode  of  application. 


Fig.  1. — Vertical  section  of  skin;    sbg,  Sebaceous  glands;  ep,  epider- 
mis; h,  hair;  d,  derma  (Fox). 

Again,  the  skin  is  not  a  mere  covering  for  the  body,  but 
one  of  its  most  important  organs,  with  well-defined  func- 
tions ;  so  that,  in  order  to  obtain  a  clear  understanding 
of  the  subject,  it  is  necessary  first  to  consider  briefly  the 
functions  of  the  skin;  and,  secondly,  the  physiologic 
action  of  water. 

Description  of  the  Skin. — The  skin  is  a  very  sensitive 
and  complex  organ,  and  upon  the  condition  of  the  skin 
and  the  vicissitudes  to  which  it  is  exposed  the  health  of 
the  individual  is  dependent  to  a  very  great  degree. 


HYDROTHERAPY  13 

The  skin  is  composed  of  three  distinct  layers — the 
epidermis,  the  corium  or  true  skin,  and  the  subcutaneous 
connective  tissue.  The  appendages  of  the  skin  are  the 
hair,  nails,  the  sebaceous  and  sweat-glands.  This  com- 
plicated structure  is  supplied  with  blood-vessels,  lym- 
phatics, and  nerves. 

The  Epidermis. — The  outer  layer  of  this  is  the  horny 
layer;  when  a  blister  is  formed,  its  fluid  raises  the  entire 
epidermis  from  the  true  skin.  The  flat  scales  forming  the 
homy  layer  are  continually  being  thrown  off;  this  process 
of  desquamation  is  increased  by  the  friction  of  the  clothes, 
of  bathing,  massage,  and  so  forth,  and  is  as  constantly 
being  replaced  by  new  cells  from  underneath. 

The  corium,  or  true  skin,  is  the  most  important  part  of 
the  integument.  This  is  a  thick,  felt-like  tissue  which  is 
pierced  in  all  directions  for  the  passage  of  the  blood-ves- 
sels, lymphatics,  sweat-ducts,  and  nerves,  and  affords 
lodgment  for  the  hair  follicles  and  sebaceous  glands.  The 
tension  of  the  skin  is  produced  by  its  muscular  structure 
and  elastic  network,  and  is  subject  to  temperature  changes. 
This  power  of  contractility  is  known  as  the  tone  of  the 
skin. 

The  skin  has  two  kinds  of  glands,  the  sebaceous  and 
sweat-glands.  The  sebaceous  glands  consist  of  a  gland 
structure,  with  a  short  excretory  duct,  which  opens  upon 
the  epidermis  or  into  the  hair  follicles.  These  glands 
secrete  an  oily  substance,  which  keeps  the  hair  and  skin 
soft  and  protects  them  from  the  sweat. 

There  exists  in  "^he  sebaceous  glands  of  the  skin  an 
infinite  number  of  vulnerable  points  for  infection,  and  the 
greater  part  of  the  process  of  cleanliness  is  directed  toward 
their  protection.  If  in  any  part  of  the  skin  there  is  an 
accumulation  of  bac'lli,  their  toxins,  or  excretions,  and, 
at  the  same  point,  a^  collection  of  sebum,  the  friction  of  the 
clothes,  caused  by  'he  movements  of  the  body,  becomes 
an  active  agent  in  effecting  their  absorption  by  the  skin. 
Hence,  the  scientific  basis  for  the  necessity  of  the  daily 
bath. 


14  PERSONAL  HYGIENE   FOR  WOMEN 

In  the  subcutaneous  tissue  we  find  the  fat ;  it  is  this  part 
of  the  skin  that  contributes  to  the  roundness  and  beauty 
of  the  body.  It  is  increased  by  abundant  fatty  food, 
sedentary  habits,  and  freedom  from  care. 

Functions  of  the  Skin. — The  skin  exercises  three  dis- 
tinct functions:  first,  as  an  organ  of  sense;  second,  as  an 
organ  of  excretion ;  and  third,  as  an  organ  of  heat  regula- 
tion. 

Next  to  sight,  the  sense  of  touch  is  the  most  important 
of  all  the  senses.  Through  this  sense  the  human  organism 
is  made  conscious  of  its  contact  with  the  outer  world. 
The  cutaneous  nerve-endings  stand  guard,  as  it  were,  over 
most  of  the  functions  of  the  human  body. 

The  importance  of  the  action  of  the  skin  as  an  organ  of 
excretion  will  be  better  understood  from  the  well-known 
fact  that  the  skin  is  one  of  the  most  important  aids  to  the 
kidneys.  That  the  perspiration  and  the  urine  are  to  a 
certain  extent  vicarious  excretions  has  been  proved. 

The  blood  is  the  circulating  medium  which  not  only 
serves  to  convey  nutritive  materials  from  the  stomach  to 
the  tissues,  and  the  excrementitious  materials  from  the 
tissues  to  the  excretory  glands,  but  also  to  equalize  the 
body  temperature.  It  conveys  the  surplus  heat  from  the 
interior  of  the  body  to  the  surface,  where  it  may  be  dis- 
sipated by  conduction,  radiation,  and  evaporation. 
Nearly  nine-tenths  of  the  daily  heat-loss  takes  place 
through  the  skin;  and  of  this,  one-seventh  is  due  to 
evaporation,  which  is  enormously  increased  by  perspira- 
tion. 

The  amount  of  perspiration  produced  daily  is  about 
two  pints,  or  in  the  neighborhood  of  ^  of  the  body  weight. 
This  is  double  the  amount  of  wat3r  thrown  off  by  the 
lungs.  The  watery  portions  of  the  porspiration  are  readily 
evaporated,  and  the  solid  constituen  ?  are  deposited  upon 
the  skin.  Urea  and  uric  acid,  togetl  er  with  more  subtle 
poisons,  are  found  in  the  sweat. 

Animal  Heat. — The  heat  of  the  body  is  wholly  derived 
from  foods,  which,  when  completely  cxidized  within  the 


HYDROTHERAPY  15 

body,  produce  practically  the  same  amount  of  heat  and 
energy  that  would  be  generated  by  their  combustion  out- 
side the  body. 

But  it  is  essential,  in  order  to  keep  the  body  of  warm- 
blooded animals  at  a  constant  or  normal  temperature,  that 
an  increase  in  the  heat-production  should  be  accom- 
panied by  a  corresponding  increase  in  the  heat  dissipa- 
tion; the  functions  are  reciprocal,  and  this  equilibrium 
is  regulated  and  maintained  by  a  special  nervous  and 
functional  mechanism. 

The  automatic  protective  measures  against  the  effects 
of  heat  are : 

First. — Dilatation  of  the  cutaneous  vessels  and  an 
acceleration  of  the  circulation  through  the  skin  and  the 
subcutaneous  tissue.  By  this  means  the  dissipation  of 
heat  is  increased;  the  sweat  at  the  temperature  of  the 
blood,  deposited  upon  the  surface  of  the  body,  evaporates 
under  favorable  circumstances,  and  in  this  way  consider- 
able amounts  of  heat  are  abstracted  from  the  body.  In 
consequence  of  sweating  and  its  evaporation,  the  blood 
circulating  through  the  skin  is  cooled,  and  retumuig  to 
the  internal  organs  at  a  lowered  temperature,  prevents 
their  overheating. 

Second. — Should  the  action  of  heat  be  continued  for  a 
greater  length  of  time,  a  large  amount  of  blood  will  be 
retained  in  the  skin  in  consequence  of  the  loss  of  tonicity 
of  the  cutaneous  vessels ;  the  cutaneous  circulation  will  be 
slowed,  and  thereby  the  blood,  heated  at  the  surface  of  the 
body,  is  prevented  from  returning  to  the  internal  organs 
and  so  overheating  them. 

Third. — In  consequence  of  the  accumulated  amount 
of  blood  in  the  skin,  a  diminished  amount  of  blood  will 
remain  in  the  internal  organs;  thus  their  activity,  and 
thereby  also  the  production  of  heat,  will  be  lessened. 

In  these  processes  will  be  found  a  safeguard  against  the 
excessively  rapid  penetration  of  heat  to  the  internal 
organs,  and  against  the  unduly  rapid  elevation  of  the 
body  temperature  through  thermic  influences. 


16  PERSONAL   HYGIENE   FOR   WOMEN 

As  a  result  of  the  stimulating  influence  of  cold,  there 
first  occurs  contraction  of  the  skin  and  its  vessels.  This, 
by  restricting  the  dissipation  of  heat,  brings  about  perfect 
compensation  if  the  abstraction  of  heat  be  but  slight; 
and  but  partial  compensation,  if  the  abstraction  of  heat 
is  more  marked.  In  the  latter  event  the  body  tempera- 
ture will  continue  to  decline,  to  a  greater  or  less  degree; 
in  the  former  it  will  remain  constant. 

The  role  played  by  the  skin  in  maintenance  of  the  nor- 
mal temperature  of  the  body  is  indispensable. 

The  normal  temperature  of  the  adult  human  body  is 
98.6°  F.  in  the  axilla;  the  temperature  in  the  mouth  is 
five-tenths  of  a  degree  higher  than  that  of  the  axilla,  and 
that  of  the  rectum  and  vagina  is  one  degree  higher  than 
that  of  the  mouth. 

Fasting,  sleep,  and  short  applications  of  heat  all  decrease 
heat-production;  during  sleep  the  temperature  of  the  body 
falls  half  a  degree  or  more. 

Respiration  by  the  skin  varies  from  §  to  1  per  cent. 
of  the  total  amount  of  oxygen  taken  into  the  body,  and  a 
somewhat  lower  percentage  of  carbonic  acid  is  thrown 
off  through  this  channel. 

The  skin  absorbs  substances  in  watery  solutions  with 
difficulty,  on  account  of  the  oil  lying  upon  and  in  the 
epidermis;  substances  dissolved  in  oil  and  rubbed  in  are 
more  rapidly  absorbed;  absorption  takes  place  rapidly  after 
the  skin  has  been  washed  with  ether,  chloroform,  or  alcohol. 

The  Physiologic  Effects  of  Water. — These  depend 
on  whether  the  water  is  taken  internally  or  applied  ex- 
ternally. If  applied  externally,  the  effects  will  depend 
upon  the  temperature,  whether  hot,  tepid,  or  cold; 
also  on  the  manner  of  application,  but,  most  of  all,  on 
the  length  of  time  which  it  is  applied  and  the  state  of 
health  of  the  individual. 

The  temperature  of  water  is  classified  as  very  cold,  from 
82°  to  55°  F.;  as  cold,  from  55°  to  65°  F.;  cool,  from 
65°  to  80°  F.;  tepid,  80°  to  92°  F.;  warm,  92°  to  98°  F.: 
hot,  98°  to  104°  F.;  very  hot,  104°  F.  and  above. 


HYDROTHERAPY  17 

Heat. — ^A  general  hot  bath  produces  dilatation  of  the 
vessels  of  the  skin  and  contraction  of  the  vessels  of  the 
brain;  a  general  activity  of  the  glands  of  the  skin,  both 
perspiratory  and  sebaceous.  Perspiration  may  be  pro- 
duced, either  to  the  degree  of  slight  moisture  or  of  profuse 
sweating,  according  to  the  length  of  time  and  the  intensity 
of  the  application  made.  In  a  very  hot  bath  the  rate  of 
perspiration  may  be  increased  from  fifty  to  sixty  times 
the  ordinary  amount.  The  most  pronounced  effect  pos- 
sible may  be  secured  by  either  the  electric  light  or  sun  bath. 

Loss  of  fluids  from  the  body  has  a  depressing  effect 
similar  to,  though  somewhat  less  marked  than,  that 
produced  by  bleeding,  so  that  there  is  a  vital  necessity  for 
administering  water  internally  before,  during,  and  after 
the  bath. 

Prolonged  and  repeated  perspirations  induced  by 
artificial  means  weaken  the  skin,  and  thus  lessen  its 
power  to  resist  cold  impressions,  unless  counteracted  by 
frequent  cold  applications. 

The  general  and  usual  reactions  following  the  applica- 
tions of  heat  are  atonic  and  depressing  in  character.  For 
the  most  part,  the  reactions  following  cold  applications 
are  to  be  preferred  to  those  following  hot  ones. 

The  three  great  vascular  areas  of  the  body  are  the  mus- 
cles, the  portal  system,  and  the  skin.  Each  of  these 
parts  may  be  regarded  as  a  great  reservoir,  capable  of 
retaining  a  large  part  of  the  entire  amount  of  blood  of 
the  body.  When  one  of  these  areas  is  in  a  state  of  con- 
gestion, the  others  must  be  in  a  comparative  state  of 
anemia. 

The  restorative  effects  due  to  the  application  of  heat 
are  due  partly  to  the  elimination  of  fatigue  poisons  which 
is  thereby  encouraged,  as  well  as  by  the  reflex  stimulation 
of  the  nerve-centers.  The  good  effects  are  much  more 
decided  and  lasting,  and  the  exhausting  effects  neutralized, 
if  the  hot  application  is  followed  by  a  short  cold  one. 

The  effects  of  a  neutral  bath,  92°  to  95°  F.,  is  sedative, 
diminishing  nervous  irritability. 


18  PERSONAL   HYGIENE   FOR   WOMEN 

A  hot-water  bottle  or  fomentations,  placed  over  the 
stomach  for  an  hour  or  two  after  eating,  increase  the 
gastric  secretions,  and,  when  placed  over  the  liver, 
increase  the  flow  of  bile. 

The  Physiologic  Effects  of  Cold. — In  suitable  cases  a 
short  general  apphcation  of  cold  is  a  powerful  heart  tonic. 
Cold  causes  a  contraction  of  the  vessels  of  the  skin  and 
of  those  of  the  brain,  with  a  dilatation  of  the  internal 
vessels.  There  are  pallor  and  coldness  of  the  skin,  and 
an  almost  instantaneous  suspension  of  perspiration, 
which  is  dangerous  only  when  the  body  is  in  a  state  of 
fatigue. 

If  the  application  of  cold  is  long  continued,  the  surface 
becomes  blue,  the  temperature  of  the  muscles  beneath  the 
skin  is  lowered,  thus  checking  heat-procluction  in  these 
muscles;  the  circulation  is  slowed,  and  the  heart's  action 
is  diminished  in  frequency.  There  is  a  gooseflesh  appear- 
ance of  the  skin;  a  sensation  of  chilliness,  trembling, 
shivering,  chattering  of  the  teeth;  at  first  a  quickening 
and  then  slowing  of  the  pulse,  and  deep  gasping  respira- 
tion. 

When  the  cold  application  is  considerably  prolonged, 
the  tendency  to  reaction  is  suppressed.  There  is  an  ex- 
haustion of  the  nerve-centers  as  well  as  of  the  heat- 
producing  powers  of  the  body.  Thus,  the  system  grad- 
ually loses  its  power  to  resist  the  depressing  effects  of 
cold.  The  repeated  chiUings  of  the  body  increase  the 
length  of  time  required  to  return  to  the  normal  tempera- 
ture. AppKcations  of  water  below  the  temperature  of 
the  body  always  lower  the  temperature. 

Reaction. — If  the  application  of  cold  is  of  very  short 
duration,  of  very  low  temperature,  and  given  imder  high 
pressure,  the  phenomena  of  reaction  begin  immediately 
on  its  cessation. 

The  reaction  consists  in  a  dilatation  of  the  surface 
capillaries,  with  contraction  of  the  internal  vessels;  red- 
ness of  the  skin;  the  skin  is  smooth,  soft,  and  supple; 
there  is  a  sensation  of  warmth,  comfort,  and  well-being; 


HYDROTHERAPY  19 

respiration  is  slower  and  deeper;  there  are  a  fall  of  the 
internal  temperature  and  increase  of  perspiration. 

Certain  measures  to  favor  reaction  should  be  taken 
before  the  bath,  such  as  exposure  to  the  air  of  a  warm 
room,  drinking  hot  water,  and  short  exercise  of  a  rather 
vigorous  kind. 

During  the  bath  the  measures  which  favor  reaction  are 
short,  sudden  applications  of  cold,  friction  while  in  the 
bath  with  the  hand,  and  pressure  effects  in  the  douche. 

After  the  bath  reaction  is  favored  by  vigorous  rubbing, 
a  thorough  drying  of  the  body,  warm  clothing,  warm  air 
of  the  room,  and  as  vigorous  exercise  as  the  strength  of 
the  individual  will  permit. 

Conditions  which  are  unfavorable  to  healthy  reaction 
are:  old  age,  infancy,  exhaustion,  either  temporary  or 
from  an  excessive  loss  of  sleep,  or  extreme  nervous  ex- 
haustion, obesity,  rheumatic  diathesis,  unhealthy  or 
inactive  skin,  profuse  perspiration  when  accompanied 
by  a  state  of  fatigue,  extreme  nervous  irritability,  a  very 
low  temperature  of  the  skin,  an  immediately  preceding  or 
impending  chill,  and  extreme  aversion  to  cold  applications. 

The  average  temperature  of  the  human  nude  skin  is  in 
the  neighborhood  of  90°  F.  The  difference  between  the 
temperature  of  the  skin  and  water  is  the  chief  element  in 
determining  the  reaction  of  the  individual.  It  is  evident 
that  water  at  a  temperature  of  90°  F.  would  be  neutral  or 
indifferent;  the  difference  of  intensity  of  effect  is  in  pro- 
portion to  the  difference  of  temperature  of  the  water  and 
skin.  The  duration  of  the  cold  procedure  is  an  important 
element  in  the  production  of  reaction.  It  may  be  laid 
down  as  a  rule  never  to  give  any  cold-water  application 
without  friction.  The  physical  and  psychic  state  of  the 
individual  exerts  more  or  less  influence  upon  his  reactive 
capacity.  An  anemic,  or  otheiT\ase  depressed  individual 
must  be  managed  with  great  circumspection,  because  she 
bears  heat  abstraction  badly.  The  hydriatic  procedure 
must  always  be  adapted  to  the  reactive  capacity  of  the 
bather. 


20  PERSONAL  HYGIENE   FOR  WOMEN 

The  woman  must  be  thoroughly  rubbed  after  the  bath 
until  a  good  reaction  has  occurred.  Especial  attention 
must  be  paid  to  the  feet  and  legs.  The  bather  should 
first  be  rubbed  with  a  warm  towel  or  sheet,  and  then  with 
the  bare  hands  of  the  attendant,  as  the  warm  hand  greatly 
facihtates  the  reaction.  The  bather  is  by  no  means  dry 
when  the  skin  ceases  to  feel  wet.  So  long  as  the  skin  is 
soft  and  spongy,  it  still  contains  moisture  which  has  been 
absorbed  by  the  superjficial  layers  of  the  epidermis.  The 
absorbed  moisture,  being  left  to  evaporate  after  the  bath, 
the  individual  is  liable  to  become  chilly  and  contract  a  cold, 
which  is  erroneously  attributed  to  the  bath  itself. 

Other  injurious  effects  following  imperfect  reaction 
after  the  cold  bath  are  secondary  chills  or  a  continuous 
chill  lasting  for  several  hours.  The  hands  and  feet  are 
cold,  there  is  headache,  not  infrequently  diarrhea,  and 
other  evidences  of  internal  congestion,  such  as  abdominal 
or  ovarian  pain,  vertigo,  etc. 

Reaction  may  be  favored  by  covering  the  patient  with 
blankets,  surrounding  her  with  hot-water  bottles,  and 
giving  her  hot  tea  to  drink.  Exercise  should  follow  the 
bath.  Walking  for  from  twenty  minutes  to  an  hour  is 
the  most  usual  form  of  exercise.  Very  vigorous  exercise 
for  a  short  time  cannot  be  substituted  for  moderate 
exercise  for  a  longer  time. 

The  Tonic  Effect  of  Cold  Upon  the  System. — The  effect 
of  cold  upon  the  muscles,  when  given  in  the  form  of  a  cold 
bath,  douche,  or  spray,  is  to  augment  muscular  energy 
and  tone  to  a  very  great  extent;  this  increased  muscular 
tonicity  is  the  cause  of  the  slight  shivering.  The  cold 
douche,  if  short, — one  or  two  seconds, — and  given  with  a 
pressure  of  from  25  to  30  pounds,  is  a  powerful  restorative 
in  fatigue  resulting  from  severe  muscular  effort,  but  it 
must  be  immediately  preceded  by  a  short  hot  bath,  and 
must  be  followed  by  vigorous  rubbing  and  wrapping  in  a 
hot  blanket. 

Short  cold  applications  cause  elevation  of  temperature 
and  increased  metabolism,  while  prolonged  cold  applica- 


HYDROTHERAPY  21 

tions  cause  a  fall  of  temperature  and  decrease  of  metabo- 
lism. 

The  tonic  effect  of  cold  water  is  believed  to  be  due 
to  the  stimulation  of  the  sympathetic  nerve-centers.  The 
sympathetic  nervous  system  controls  the  blood-vessels, 
heart,  the  functions  of  secretion  and  excretion;  and,  in- 
deed, all  the  vital  functions  of  the  body. 

The  sensation  of  well-being  which  accompanies  the 
reaction  following  a  general  cold  application  is  largely 
due  to  an  increased  activity  of  the  cerebral  circulation. 
Cold  water  is  a  physiologic  tonic,  and  the  cold  bath,  prop- 
erly employed,  increases  the  vital  resistance  to  pathologic 
processes. 

All  applications  of  water  at  a  temperature  low  enough 
to  provoke  vital  resistance  are  tonic;  hence,  tonic  effects 
are  produced  by  all  temperatures  below  90°  F.,  but  the 
most  certain  and  pronounced  results  are  obtained  from 
the  douche  in  every  form,  which  adds  mechanical  impact 
to  the  thermic  effects  of  cold.  The  most  durable  tonic 
effects  are  produced  by  the  frequent  use  of  very  cold  and 
very  short  baths. 

A  tepid  bath  causes  a  lowering  of  the  body  temperature. 

The  Chief  Varieties  of  Baths. — These,  in  the  order 
of  frequency  with  which  they  are  used,  are:  ablutions; 
tub;  foot-tub;  sitz;  salt  sponge;  wet  sheet;  shower; 
Turkish;  horizontal  jet;  needle;  fan  douche;  Scotch  douche; 
percussion  douche;  Roman  and  electric-light  baths. 

Ablutions  or  Sponge  Baths. — These  baths  are  of 
universal  use.  The  sponge  is  one  of  the  dirtiest  and  most 
impossible  articles  of  the  toilet  to  clean  and  to  keep  clean. 
It  is  a  collector  of  dirt  and  germs,  and  should  be  banished 
from  every  bath-room  and  from  every  house.  It  is  not 
sufficient  that  each  member  of  the  family  should  have 
her  own  sponge;  it  is  quite  possible  for  the  individual  to 
become  infected  or  reinfected  from  her  own  sponge. 
Incidentally,  it  does  not  afford  sufficient  friction,  and  thus 
does  not  favor  reaction.  In  taking  ablutions,  the  ap- 
plication of  water  may  be  made  with  the  hand,  though  it 


22  PERSONAL  HYGIENE   FOR  WOMEN 

is  best  made  by  means  of  a  wash  towel.  The  good  effects 
of  the  simple  ablution  will  be  greatly  enhanced  by  the  use 
of  the  hat  tub,  and  this  especially  where  there  is  no  bath- 
tub in  the  house. 

When  the  bath  is  taken  for  the  purpose  of  cleanliness, 
the  water  should  be  warm  or  hot,  and  pure  Castile  soap  is 
one  of  the  best  that  can  be  used.  If  the  skin  is  rough,  a 
good  sand  soap  will  be  more  beneficial.  The  bath  should 
be  completed  by  dashing  cold  water  over  the  body  with 
the  wash-towel. 

The  body  must  be  quickly  and  thoroughly  dried  by 
means  of  a  rough  bath-towel.  After  this,  the  skin  may 
be  still  further  toned  up  by  a  good  alcohol  rub. 

If  the  ablution  is  taken  simply  for  the  tonic  effect,  it  is 
generally  taken  on  rising  in  the  morning,  and  the  water 
used  is  cold.  The  ablution  may  be  confined  to  the  upper 
part  of  the  body,  that  is,  the  chest  and  back ;  and  consists 
in  friction  with  a  rough  wash-towel,  followed  by  dashing 
the  water  over  the  body ;  followed  by  brisk  friction  with 
a  rough  bath-towel.  This  procedure  causes  a  marked 
stimulation  of  the  heart  and  lungs,  and  is  followed  by  a 
rise  of  temperature. 

In  winter  all  baths  must  be  taken  in  a  warm  room. 

There  is  a  decided  increase  of  muscular  and  mental 
capacity  after  the  cold  ablution,  demonstrating  the  tonic 
effect  it  has  produced. 

The  cold  ablution  may  also  serve  as  an  introductory 
to  other  and  more  heroic  hydriatic  procedures.  If  the 
reaction  is  not  good,  water  at  a  higher  temperature  should 
be  used,  and  only  small  portions  of  the  body  should  be 
attacked  each  day,  followed  always  by  brisk  friction. 
As  the  reaction  becomes  better,  the  temperature  of  the 
water  should  be  gradually  lowered  from  day  to  day. 

There  must  be  a  decided  sensation  of  warmth  of  the 
body  before  proceeding  to  take  any  form  of  cold  bath. 
This  may  be  induced  by  sipping  a  cupful  of  hot  water 
before  rising,  and  then  being  well  covered  with  the  bed- 
clothes until  the  body  is  in  a  glow.     In  conditions  of 


HYDROTHERAPY  23 

anemia  or  neurasthenia,  where  the  circulation  is  markedly 
poor,  in  addition  to  drinking  the  hot  water,  the  bather 
may  stand  on  hot  blankets  while  taking  the  cold  ablu- 
*tion,  and  after  it  be  rubbed  briskly  with  hot  towels. 

Nothing  is  gained,  and  a  great  deal  of  harm  is  done,  by 
trying  to  persevere  in  the  daily  cold  ablution  when  it  is 
followed  by  a  pallor  of  the  skin,  chilliness,  etc. 

The  Tub  Bath. — This  is  much  more  refreshing,  more 
salutary,  and  may  be  used  to  produce  a  much  greater 
variety  of  effects  than  the  simple  ablution.  Tub  baths 
may  be  classified  according  to  the  amount  of  water  in  the 
tub  as  half  or  full  tubs;  and  again,  according  to  the  tem- 
perature of  the  water,  as  warm,  tepid,  hot,  and  cold. 
The  half  tub  contains  about  30  gallons  of  water. 

In  a  general  way  it  may  be  said  that  the  half  tub  of 
warm  water  is  used  for  the  purpose  of  cleanliness;  the  hot 
baths  for  breaking  up  colds,  for  rheumatism,  etc.;  the 
tepid  bath  to  allay  nervousness;  and  the  full  cold  tub,  for 
the  tonic  morning  dip. 

For  cleansing  purposes  the  so-called  half  tub,  that  is, 
the  tub  contains  a  sufficient  amount  of  water  to  reach 
above  the  pelvis  when  one  is  seated  in  the  tub,  is  used. 
The  temperature  ranges  from  98°  to  102°  F.  Five  min- 
utes is  as  long  as  the  bather  should  remain  in  the  tub, 
as  aU  hot  baths  are  more  or  less  exhausting.  After  an 
initial  immersion  in  the  water,  the  scrub  takes  place  by 
means  of  the  Turkish  bath-towel,  or,  better,  by  the  use  of 
the  flesh  brush.  If  there  is  a  shower  attached,  the  hot  bath 
should  always  be  followed  by  a  brief  cold  shower;  if  not, 
the  cold  water  should  be  turned  on  and  dashed  over  the 
body  by  means  of  the  wash-towel.  This  closes  up  the 
pores  of  the  skin,  prevents  the  profuse  perspiration  from 
taking  place  that  so  often  follows  a  hot  bath,  and  greatly 
diminishes  the  susceptibility  to  taking  cold.  An  alcohol 
rub  completes  the  procedure.  This  insures  a  further 
toning  up  of  the  cutaneous  vessels.  A  smaU  quantity 
of  alcohol  is  poured  into  the  hand  and  applied  to  a  limited 
area  of  the  body.     It  is  well  rubbed  in  with  friction  until 


24  PERSONAL  HYGIENE  FOR  WOMEN 

the  alcoliol  has  wholly  evaporated.  Beginning  with  the 
arms,  the  legs,  chest,  and  back  are  successively  gone  over. 

The  hot  bath  is  best  taken  immediately  before  retiring, 
and  should  not  be  repeated  oftener  than  twice  a  week. 
Retiring  to  bed  at  once,  the  bed  acts  as  the  cooling  cham- 
ber of  the  Turkish  bath.  The  hot  bath  is  most  restful, 
and,  except  in  rare  cases,  tends  to  the  production  of 
refreshing  sleep. 

If  the  bather  has  a  weak  heart,  suffers  from  shortness 
of  breath,  or  is  weak  from  any  cause  whatever,  she  should 
only  take  a  half  tub  bath,  since  it  has  been  learned  from 
experience  that  when  the  water  covers  the  entire  body, 
there  is  increased  difficulty  in  the  respiration,  and  the 
heart's  action  often  becomes  embarrassed,  palpitation 
of  the  heart  is  experienced,  with  a  feeHng  of  impending 
suffocation.  There  is  sometimes  also  a  feeling  of  faint- 
ness.  On  getting  into  the  tub,  the  temperature  of  the 
room  should  never  be  above  68°  to  70°  F. 

The  Full  Tub  or  Immersion  Bath. — In  this  form  of  bath 
there  is  a  complete  submersion  of  the  body  in  the  water, 
so  that  the  water  reaches  the  under  surface  of  the  chin, 
the  head  of  the  bather  resting  on  a  cross  strap,  being  the 
only  portion  of  the  body  uncovered  by  the  water. 

If  the  bath  is  tepid,  that  is,  has  a  temperature  of  from 
80°  to  90°  F.,  great  care  should  be  taken  to  have  the 
chest  covered,  in  order  to  prevent  pulmonary  congestion. 
This  is  best  accomplished  by  placing  a  Turkish  towel, 
wrung  out  of  hot  water,  about  the  chest  and  shoulders 
of  the  bather  just  after  she  enters  the  tub. 

If  the  bath  is  hot,  from  98°  to  104°  F.,  before  entering 
the  bath  the  face  and  neck  are  rubbed  with  cold  water, 
in  order  to  relax  the  vessels  of  the  brain  and  so  prevent 
cerebral  anemia.  Except  when  the  hot  bath  is  given  for 
especial  therapeutic  purposes,  as  for  rheumatism,  cystitis, 
colic,  etc.,  it  should  always  be  followed  by  a  cold  applica- 
tion. 

The  Cold  Dip. — For  the  dip,  the  tub  is  filled  with 
water  at  a  temperature  of  from  65°  to  55°  F.    The  dura- 


HYDROTHERAPY  25 

tion  of  the  dip  varies  from  two  or  four  seconds  to  one  or 
two  minutes.  The  bather  should  wet  the  face  and  chest 
before  entering  the  water.  It  is  best  to  enter  the  bath 
suddenly,  as  the  sensation  of  cold  is  thus  far  less  notice- 
able than  when  the  bath  is  entered  gradually.  If  the  stay 
in  the  tub  is  more  than  momentary,  vigorous  rubbing 
must  be  kept  up  during  the  entire  time  spent  in  the  tub. 

For  persons  in  good  health  a  cold  dip  on  rising  in  the 
morning  is  excellent.  It  creates  an  appetite,  accelerates 
the  circulation,  arouses  the  nervous  system,  and  produces 
decided  exhilarating  effects  in  those  who  are  strong 
enough  to  react  after  it.  When  employed  for  this  pur- 
pose, the  immersion  should  not  be  more  than  from  three 
to  fifteen  seconds.  The  bather  must  rub  herself  vigor- 
ously while  in  the  tub,  and  follow  the  bath  with  brisk 
toweling  and  plenty  of  friction.  She  should  then  take 
moderately  active  exercise  for  fifteen  to  twenty  minutes. 

For  any  one  just  beginning  to  take  the  cold  dips,  the 
temperature  of  the  water  should  be  just  1  degree  below 
that  of  the  body,  and  gradually  lowered  by  a  drop  of  1 
degree  every  morning  or  two.  Or,  the  dip  may  be  pre- 
ceded by  a  preliminary  warm  bath  or  warm  shower. 

The  salient  point  in  connection  with  bathing  is  not  to 
allow  the  skin  to  lose  heat  too  rapidly.  To  apply  this  as  a 
warning  in  the  case  of  cold  baths:  it  has  been  estimated 
that  the  heat  loss  from  the  body  immersed  in  cold  water 
at  the  temperature  of  86°  F.  is  double  the  normal;  at 
77°  F.,  three  times,  and  at  68°  F.,  five  times,  the  normal. 

The  daily  use  of  the  cold  dip  for  those  who  are  able  to 
react  after  it  is  one  of  the  best  means  of  fortifying  the 
system  against  both  acute  and  chronic  diseases. 

Contraindications. — The  use  of  the  cold  dip  is  contra- 
indicated  for  young  children,  the  aged,  and  in  run-down 
conditions  of  the  system;  in  all  cases  where  the  action  of 
the  heart  is  weak,  in  Bright's  disease,  or  in  any  acute  or 
chronic  congestion  of  the  kidneys;  in  all  acute  inflamma- 
tions, as  inflammation  of  the  bowels,  peritonitis,  or  in- 
flammation of  the  uterus  and  ovaries. 


26  PERSONAL   HYGIENE   FOR   WOMEN 

Alkaline  Baths. — For  these  baths  from  4  to  12  ounces 
of  the  carbonate  of  soda  should  be  used  to  30  gallons  of 
water.  The  water  should  have  a  temperature  of  from 
92°  to  96°  F.  This  bath  is  useful  in  many  forms  of  skin 
disease,  and  relieves  the  itching  of  jaundice  and  urticaria. 

Saline  Baths. — The  typical  saline  bath  is  the  salt- 
water bath.  Sea-water  contains  in  solution  from  J  to 
I  pound  of  solids  to  the  gallon  of  water.  The  principal 
ingredients  are  common  salt,  magnesium  chlorid,  and 
magnesium  sulphate.  These  substances  have  a  decidedly 
stimulating  effect  upon  the  skin  and  encourage  reaction. 
For  an  artificial  sea-water  bath,  8  pounds  of  sea-salt 
should  be  used  to  30  gallons  of  water. 

Ordinary  coarse  salt  is  purer,  contains  from  97  to  98 
per  cent,  of  the  chlorid  of  sodium,  is  cleaner,  and  makes 
a  clearer  solution,  and  it  dissolves  in  about  one-third  of 
the  time  required  for  sea  salt,  and  can  be  obtained  for 
about  one-third  of  the  cost. 

As  a  cleansing  agent,  a  5  per  cent,  brine  is  equal  or 
superior  to  soap.  Further,  the  axilla  and  hairy  parts 
remain  clean  and  sweet  for  a  much  longer  time  than  after 
the  use  of  soap.  These  brine  baths,  taken  three  times  a 
week,  are  followed  by  a  great  improvement  in  the  general 
health. 

The  Rain  Douche  or  Shower  Bath. — The  shower  is 
the  most  tonic  of  all  the  baths  that  can  be  taken  at  home, 
and  no  bath-room  should  be  considered  complete  without 
it.  In  this  form  of  douche  the  water  is  projected  through 
a  perforated  disc,  falling  upon  the  bather  in  a  number  of 
fine  streams.  It  is  necessary  for  the  bather  to  wear  a 
rubber  cap  in  order  to  keep  the  hair  dry.  In  taking  the 
shower  bath  the  bather  stands  up;  the  disc  is  generally 
placed  about  3  feet  above  the  head.  The  water  should 
be  allowed  to  fall  first  upon  the  feet,  then  the  hands,  arms, 
shoulders,  back,  and,  lastly,  upon  the  chest  and  abdomen. 
The  bather  should  keep  in  active  motion  during  the  ap- 
plication, flexing  the  limbs,  and  rubbing  the  chest  with 
the  hands.     At  the  beginning  of  the  shower  the  hands 


HYDROTHERAPY  27 

should  be  placed  over  the  chest,  in  order  to  protect  the 
precordial  region  from  the  impact  of  the  water. 

The  cold  shower  should  be  preceded  by  some  kind  of  a 
heating  process — either  a  hot  plunge  or  a  hot  shower  bath. 
A  shower  of  from  100°  to  104°  F.  may  be  applied  for  one 
to  three  minutes  before  the  cold  application.  A  cool 
shower  of  75°  to  65°  F.  is  an  excellent  training  for  persons 
who  are  sensitive  to  cold.  The  neutral  shower,  92°  to 
97°  F.,  given  for  three  to  five  minutes,  is  sedative  in  its 
effects. 

The  cold  shower,  60°  to  70°  F.,  duration  from  five  to 
thirty  seconds,  is  useful  in  phlegmatic  neurasthenics  and 
dyspeptics;  sedentary  people  in  whom  the  general  meta- 
bolic activity  is  diminished ;  also  in  obesity  and  in  all  cases 
after  a  sweating  process.  By  standing  in  hot  water  the 
bather  is  much  more  tolerant  of  cold. 

The  neutral  shower  is  one  of  the  most  effective  measures 
for  the  relief  of  insomnia;  especial  attention  should  be 
given  to  the  back  and  legs.  The  action  is  quicker  than 
that  of  the  neutral  immersion  bath. 

As  a  hygienic  measure,  the  shower  bath  offers  a  most 
agreeable  and  rapid  means  of  cleansing  the  whole  surface 
of  the  body. 

Since  the  effect  of  the  douche  depends  on  the  pressure, 
it  will  be  readily  understood  that  the  hose  attached  to  the 
faucet  of  the  domestic  bath-tub  is  merely  a  sprinkler, 
and  not  a  douche,  in  the  proper  sense  of  the  word.  Such 
a  procedure  can  only  be  tolerated  by  the  most  robust. 
In  the  upper  stories  of  most  city  houses  the  pressure  is 
probably  not  more  than  from  3  to  10  pounds;  the  stream 
of  water  from  the  sprinkler  is  really  only  a  drizzle;  the 
mechanical  effects  being  so  slight,  there  is  no  reaction 
produced ;  the  result  is  that  its  use  is  followed  by  a  feeling 
of  chilliness  and  depression. 

The  Hot  Foot-bath. — The  temperature  of  this  bath 
should  be  at  the  beginning  from  102°  to  104°  F,,  and  the 
duration  from  three  minutes  to  half  an  hour.  The  pail 
is  nearly  filled  with  water,  care  being  taken  that  it  shall 


28  PERSONAL  HYGIENE   FOR  WOMEN 

not  be  so  full  as  to  overrun  when  the  feet  and  legs  of  the 
bather  are  put  in.  A  blanket,  closely  wrapped  about  the 
patient  and  the  pail,  should  come  up  above  the  knees. 
As  the  water  cools  off,  hot  water  should  be  added. 

This  form  of  bath  is  most  commonly  used  to  relieve 
congestion  and  inflammation.  The  dilatation  produced  in 
the  blood-vessels  of  the  feet  and  legs  relieves  congestion  of 
the  brain  and  the  organs  of  the  upper  half  of  the  body, 
as  well  as  of  the  pelvic  viscera.  It  should  be  taken  imme- 
diately before  retiring. 

The  Sitz  Bath. — The  sitz  or  hip  bath  requires  a  tub 
made  for  that  particular  purpose.     The  back  of  the  tub, 


Fig.  2. — Sitz-bath  tub  made  of  tin  (Ashton). 

which  is  most  commonly  made  of  tin,  is  cut  high,  while  the 
front  must  be  sufficiently  low  for  the  patient  to  sit  com- 
fortably in  it,  without  undue  pressure  being  made  on  the 
under  side  of  the  knees. 

The  tub  is  half  filled  with  water  of  the  prescribed  tem- 
perature. It  is  well  to  begin  with  water  at  a  temperature 
of  102°  F.,  and  increase  the  temperature  while  the  patient 
is  in  the  tub,  making  it  as  hot  as  is  comfortable. 

In  giving  all  hot  baths  a  thermometer  must  be  used,  and 
a  word  of  warning  must  be  given  about  adding  hot  water 


HYDROTHERAPY  29 

in  case  of  sickness,  as  well-authenticated  cases  of  paral- 
ysis are  recorded  in  which  the  temperature  sense  of  the 
patient  was  lost,  and,  in  adding  hot  water,  it  was  raised 
to  such  a  temperature  that  the  legs  and  feet  of  the  patient 
were  scalded. 

During  the  sitz  bath  the  patijnt  keeps  on  her  stockings 
and  bedroom  slippers,  and,  unless  friction  is  ordered,  the 
entire  body,  as  well  as  the  feet  and  legs,  are  enveloped  in 
blankets. 

The  duration  of  this  bath  is  from  three  to  ten  minutes. 
This  bath  is  especially  useful  in  restoring  the  menstrual 
function  when  it  has  been  suspended  as  the  result  of 
chill  or  other  causes;  also,  for  relieving  hemorrhoids, 
uterine  colic,  neuralgia  of  the  ovaries,  and  inflammation 
of  the  bladder. 

To  prolong  the  effect  of  the  bath  the  patient  may  be 
put  to  bed  wrapped  up  in  her  blankets.  In  cold  weather 
it  is  a  good  precautionary  measure  to  have  the  bed  heated 
with  hot-water  bottles,  in  order  to  prevent  chilling. 

Technic  of  the  Wet  Sheet. — The  temperature  of  the 
room  should  be  not  less  than  70°  F.;  having  taken  a  glass 
of  hot  water  as  a  preliminary  procedure,  the  patient 
stands  on  a  warm  blanket.  A  linen  sheet  of  coarse 
texture  is  very  loosely  wrung  out  of  water  at  a  tempera- 
ture of  80°  F.,  reduced  daily  until  it  reaches  70°  to  65°  F. 
The  sheet  is  applied  under  the  right  axilla  of  the  patient; 
pressing  the  sheet  firmly  to  her  with  her  right  arm,  the 
patient  turns  around,  and  the  attendant  draws  the  sheet 
snugly  around  her.  When  the  entire  body  is  covered,  the 
upper  border  of  the  sheet  is  tucked  in  around  the  neck 
and  the  lower  border  around  the  legs.  The  attendant 
now  makes  rapid  passes  over  the  sheet,  up  and  down  the 
back,  sides,  and  lower  extremities,  with  outstretched 
hands,  occasionally  slapping  the  surface  to  increase  the 
mechanical  irritation.  The  duration  of  the  procedure 
varies  with  the  object  in  view.  After  the  rub,  the  sheet 
is  dropped  and  the  patient  enveloped  in  a  hot  sheet,  with 
which  she  is  rapidly  dried,  and  she  herself  is  given  hot 


30         PEESONAL  HYGIENE  FOR  WOMEN 

towels  to  aid  in  the  process.  If  the  reaction  is  not  good, 
friction  may  be  given  with  the  bare  hand  or  with  a  hair 
glove. 

This  cold  rub  is  generaUy  given  in  the  morning  on  rising, 
while  the  patient  is  still  warm  from  the  bed. 

It  should  be  followed  by  a  cup  of  hot  milk.  The  patient 
makes  her  toilet,  has  breakfast,  and  should  then  go  out- 
of-doors  for  a  brisk  walk. 

The  indications  for  the  use  of  this  procedure  are  anemia 
of  feeble  persons,  and  neurasthenia  and  digestive  distur- 
bances in  the  same  class  of  patients. 

Wet  Hand  Rubbing. — If  the  patient  is  too  feeble  to  be 
out  of  bed,  very  similar  results  can  be  obtained  by  this 
method.  The  bed  must  be  protected  by  means  of  a  rub- 
ber sheet,  over  which  the  muslin  sheet  is  spread.  A 
dry  towel  protects  the  hair  and  ears.  The  attendant 
stands  facing  the  patient,  dips  both  hands  into  the  water, 
then  applies  them,  one  to  each  side  of  the  patient's  face, 
covering  as  large  an  area  as  possible.  Friction  is  made 
from  the  median  line  outward,  the  tips  of  the  fingers 
sweeping  over  the  brow,  and  describing  a  sort  of  semicircle 
along  the  cheeks  to  the  under  side  of  the  jaw.  This 
movement  is  repeated  from  three  to  six  times. 

Next,  the  application  is  made  to  the  chest ;  both  hands 
are  emploj^ed.  First  the  upper  part  and  then  the  sides 
are  rubbed  vigorously,  then  the  abdominal  surface.  After 
the  entire  chest  has  been  gone  over  three  or  four  times, 
with  quick  short  movements  of  considerable  pressure,  the 
towel  is  thrown  over  the  chest  and  it  is  dried  rapidly. 
The  rubbing  is  continued  imtil  the  surface  is  reddened. 
The  face  is  not  to  be  dried  until  the  end,  as  it  is  desirable 
that  these  parts  should  be  cooled  by  evaporation. 

The  object  of  making  the  application  to  the  chest  before 
proceeding  to  the  other  parts  of  the  body  is  to  stimulate 
the  action  of  the  heart  and  lungs,  thereby  promoting 
reaction. 

The  arms  next  receive  attention — first  one,  and  then  the 
other.     The  attendant  grasps  the  patient's  hand  with  her 


HYDROTHERAPY  31 

left,  while  with  the  other  she  vigorously  rubs  the  arm  with 
long  strokes,  from  the  wrist  to  the  shoulder,  her  hand 
being  kept  wet  and  cold  by  dipping  in  the  basin  after 
every  three  to  six  strokes. 

On  finishing  the  arm,  the  attendant  rubs  the  hand 
between  her  own,  and  ends  with  one  or  two  smart  blows 
upon  the  palm  with  the  flat  of  the  hand.  The  arm  is 
then  enveloped  and  thoroughly  rubbed  wnth  a  rough 
towel  until  well  reddened.  It  is  then  covered  with  the 
blanket,  and  the  other  arm  is  treated  in  the  same  way. 

Attention  is  next  given  to  the  abdomen.  Friction  is 
applied  first  transversely,  the  rubbing  being  done  alter- 
nately with  the  two  hands,  then  in  a  circular  manner, 
following  the  course  of  the  colon.  The  thighs,  legs,  and 
feet  are  then  treated,  one  only  being  uncovered  at  a  time. 

The  patient  then  turns  upon  the  face,  with  the  arms 
folded  beneath  the  forehead,  so  as  to  draw  the  shoulder- 
blades  upward  and  outward  and  to  flatten  the  surface 
of  the  back  as  much  as  possible.  The  attendant  then 
applies  the  hands,  first  to  the  back  and  sides  of  the  neck, 
extending  the  fingers  so  as  to  reach  around  to  the  front  of 
the  neck.  The  upper  part  of  the  back,  the  shoulders,  the 
middle  and  lower  parts,  and  the  sides  of  the  trunk,  lastly, 
the  whole  length  of  the  spine,  are  treated  by  a  few  vigorous 
strokes.  As  quickly  as  a  part  is  dried  it  should  be  cov- 
ered. 

Not  more  than  five  to  ten  seconds  should  be  given  to 
the  rubbing  of  any  part  with  the  wet  hand  before  the 
application  of  the  towel.  If  the  rubbing  is  insuflacient 
to  produce  reddening  of  the  part,  light  percussion  should 
be  made  use  of  after  drying.  Good  reaction  should  be 
procured  in  each  area  before  proceeding  to  another  part, 
and  the  skin  must  be  warm  at  the  time  of  the  treatment. 

The  temperature  of  the  room  should  be  not  less  than 
70°  F.,  and  that  of  the  water  85°  F.,  gradually  decreased 
by  one  degree  each  day  until  70°  F.  is  reached.  The  hand 
of  the  attendant  is  made  wet  without  dripping. 

The  feeble  neurasthenic  patient  experiences  after  the 


32  PERSONAL  HYGIENE   FOR  WOMEN 

cold  rub  a  delightful  sensation  of  increased  vigor  and 
relief  from  malaise  and  nervousness.  The  warmth  of  the 
hand  of  the  attendant,  the  rubbing,  and  the  small  amount 
of  water  used  all  tend  to  promote  reaction,  so  that  it  may 
be  said  that  there  is  no  patient  too  feeble  for  this  pro- 
cedure. 

The  Salt  Glow. — For  this  the  ordinary  cooking-salt  is 
about  the  right  degree  of  coarseness.  The  salt  is  slightly 
moistened,  and  is  applied  to  the  surface  of  the  body  with 
friction  movements,  the  amount  of  reaction  being  ad- 
justed to  the  patient's  sensation.  With  very  thin-skinned 
patients  abrasion  and  irritation  of  the  skin  may  easily  be 
produced.  In  that  case  it  is  necessary,  instead  of  apply- 
ing the  salt  directly  to  the  skin,  to  make  a  saturated  solu- 
tion of  salt  in  water,  and  apply  it  in  the  same  way  that  the 
cold  rub  is  given. 

After  the  application,  the  salt  which  adheres  to  the  skin 
may  be  rerroved  by  the  shower  or  spray.  In  feeble 
patients  a  dash  of  warm  water  should  be  given  before  a 
final  dash  of  cold  water. 

The  salt  glow  is  a  tonic  measure  of  high  value,  especially 
in  feeble  persons  whose  heat-producing  capacity  is  small. 
Its  use  must  be  avoided  in  eczema  and  all  other  forms  of 
skin  disease. 

Salt  Ablution. — As  the  name  indicates,  this  is  a  salt- 
water bath,  and  the  best  results  are  obtained  by  using 
a  saturated  solution,  which  is  in  the  proportion  of  1  pint 
of  salt  to  1  gallon  of  water.  Sea-salt  is  the  best,  but,  if 
that  cannot  be  obtained,  ordinary  salt  may  be  used. 

If  there  is  no  bath-tub  in  the  house  an  ordinary  wash- 
bowl may  be  used,  but  the  bath  is  most  effective  when 
taken  in  the  tub.  The  salt  and  water  are  put  in  a  papier- 
mache  pail,  which  is  placed  at  the  foot  of  the  tub.  The 
chilliness  which  might  be  caused  by  sitting  on  the  cold 
porcelain  is  avoided  by  placing  a  heavy  folded  bath-towel 
on  the  bottom  of  the  tub.  In  cold  weather  the  tub 
should  be  previously  heated  by  allowing  the  hot  water 
to  run  in. 


HYDROTHERAPY  33 

The  salt  water  feels  very  much  colder  than  plain  water 
at  the  same  temperature.  It  is  well  to  begin  with  a  tem- 
perature of  from  90°  to  85°  F.,  and  gradually  lower  the 
temperature  until  70°  F.  is  reached. 

The  water  is  applied  by  means  of  a  Turkish  wash- 
towel,  accompanied  by  vigorous  friction,  beginning  with 
the  face  and  neck,  arms,  legs,  back,  and,  lastly,  the  chest 
and  abdomen  are  gone  over.  After  that,  the  water  is 
dashed  over  the  entire  body,  and  is  followed  by  a  brisk 
toweling  and  friction  with  the  hands  or  hair  glove. 
The  salt  water  should  not  be  washed  off,  except  in  those 
rare  cases  where  it  causes  a  disagreeable  sensation;  it  is 
then  removed  by  the  use  of  the  hot  followed  by  the  cold 
shower,  as  previously  directed. 

Indications  for  Its  Use. — It  is  an  excellent  nerve  tonic 
in  cases  of  depression  with  loss  of  appetite,  insomnia, 
etc.,  also  in  anemia  and  neurasthenia.  In  this  class  of 
cases  it  is  best  taken  in  the  afternoon,  on  rising  from  the 
siesta,  and  just  before  dressing  for  dinner.  It  is  especially 
refreshing  in  the  hot  weather. 

Its  use  is  contraindicated  under  the  same  conditions  that 
other  cold  baths  are,  and  must  never  be  taken  when  the 
bather  has  a  tendency  to  chilliness. 

The  various  kinds  of  baths  previously  described  can  aU 
be  obtained  in  the  home,  but  the  Turkish  bath,  with  its 
various  accessories,  can  only  be  taken  in  a  properly 
equipped  bathing  establishment. 

The  Turkish  Bath. — This  form  of  bath  dates  back  to 
the  time  of  the  Romans.  The  essential  features  of  a 
modem  establishment  are:  dressing-rooms;  a  warm  room, 
with  a  temperature  of  from  110°  to  130°  F.;  a  hot  room, 
temperature  of  150°  to  170°  F.;  a  steam  room;  a  shampoo 
room;  a  douche  apparatus;  a  plunge  bath,  and  a  cooling 
room.  In  many  establishments  there  is  only  one  hot, 
dry-air  room.  The  air  of  the  room  may  be  heated  by 
steam-coils. 

The  bather,  having  disrobed,  is  enveloped  in  a  sheet, 
and  enters  the  hot  room,  where  she  reclines  on  a  steamer- 

3 


34  PERSONAL   HYGIENE   FOR  WOMEN 

chair.  A  towel  wrung  out  of  cold  water  is  placed  on  the 
forehead  and  changed  as  often  as  it  becomes  hot.  The 
bather  should  drink  a  glass  of  cold  water  immediately 
before  or  on  entering  the  hot  room,  and  several  glasses 
should  be  taken  at  intervals  during  her  stay  in  this  room. 

The  skin  is  highly  stimulated  and  profuse  perspiration 
results.  The  profuse  sweating  promotes  absorption  from 
the  alimentary  canal,  and  so  is  a  powerful  stimulant  to 
nutrition.  It  also  emphasizes  the  necessity  for  copious 
water-drinking. 

Great  harm  often  results  from  a  too  prolonged  stay  in 
this  room.  Ordinarily,  the  bather  should  leave  the  room 
as  soon  as  free  perspiration  is  established;  that  is,  in  from 
fifteen  minutes  to  half  an  hour. 

From  this  room  the  bather  next  enters  the  Russian 
bath  or  steam  room.  It  is  very  much  more  agreeable  to 
have  very  little  steam  in  the  room  on  entering;  when  the 
steam  is  very  dense,  a  feeling  of  suffocation  may  occur. 
Any  one  with  a  weak  heart  should  avoid  the  steam  room 
altogether,  as  it  is  apt  to  cause  a  sense  of  great  oppression. 
For  the  complexion,  bronchitis,  or  laryngitis,  it  is  excellent. 

From  the  hot  room  the  bather  goes  to  the  shampoo- 
room,  where,  lying  upon  a  marble  slab,  she  is  first  gone 
over  from  head  to  feet  by  the  wet  hands  of  the  attendant. 
This  manipulation  removes  the  layer  of  cuticle  which  has 
been  loosened  by  the  free  perspiration.  These  rubbings 
and  strokings  are  continued  until  the  skin  feels  smooth 
and  polished. 

The  bather  is  next  shampooed  with  soap  and  water, 
applied  with  a  bath-brush.  This  may  in  turn  be  followed 
by  a  salt  rub.  After  this  comes  a  douche,  given  with  a 
horizontal  jet,  at  a  temperature  of  104°  to  106°  F.,  fol- 
lowed by  a  cold  douche. 

If  the  bather  is  a  strong  woman,  she  may  now  enter  the 
cold  plunge.  The  temperature  of  this  should  be  from  70° 
to  60°  F.;  this  must  only  be  a  quick  dip.  She  is  then 
vigorously  rubbed  and  dried.  After  this  she  lies  down  in 
the  cooling  room  and  has  an  alcohol  rub,  which  completes 


HYDROTHERAPY  35 

the  procedure.  She  should  rest  here  for  half  an  hour  at 
least  before  dressing.  The  pulse  should  be  normal  and 
the  skin  perfectly  dry  before  she  dresses  and  goes  out  on 
the  street. 

In  winter,  instead  of  the  ordinar^^  alcohol  rub  which  is 
given,  it  is  much  better  to  have  a  thorough  massage  with 
cocoa-butter  or  almond  oil — the  so-called  Roman  bath. 
Just  following  the  Turkish  bath  much  of  this  oil  will  be 
absorbed,  which  is  beneficial  for  thin  people,  and,  in  any 
case,  it  will  lessen  the  danger  of  getting  chilled  on  going 
out  into  the  cold  air. 

The  woman  unaccustomed  to  these  baths  should  under 
no  circumstances  go  to  a  Turkish  bath  without  consulting 
her  physician,  as  great  harm  might  result.  The  bath 
should  not  be  taken  oftener  than  twice  a  week,  unless  by 
special  orders  of  the  physician.  Care  must  be  taken  not 
to  overuse  them,  as  frequent  and  prolonged  exposures 
to  the  sedative  influence  of  heat  is  very  debilitating. 
The  wise  woman  will  provide  her  own  bathing  cap,  bath- 
brush,  and  straw  sandals. 

The  use  of  the  Turkish  bath  is  indicated  in  rheumatism, 
toxemia,  chronic  dyspepsia,  biliousness,  obesity,  sciatica, 
and  lumbago. 

The  contraindications  to  its  use  are,  in  Bright's  disease 
of  the  kidneys,  in  most  pulmonary  affections,  in  the  ad- 
vanced stages  of  arteriosclerosis,  and  in  diabetes  with 
emaciation. 

The  Electric-light  Bath. — This  is  now  frequently 
used  instead  of  the  hot-air  room  of  the  Turkish  bath,  and 
possesses  many  advantages.  A  cabinet  is  lined  on  three 
sides  with  mirrors,  on  which  are  arranged  50  or  60 
electric-light  bulbs;  the  mirrors  multiply  the  number  of 
lights  by  reflection.  A  stool  is  placed  in  the  cabinet  for 
the  patient  to  sit  on,  while  the  head  protiiides  above  the 
top,  which  is  closed.  By  means  of  switches  and  a  proper 
grouping  of  the  lamps  in  wiring,  the  number  of  lights,  and 
so  the  temperature,  can  be  instantly  and  perfectly  con- 
trolled.    The  heat  is  derived  by  radiation,  so  that  it  is 


36  PERSONAL  HYGIENE  FOR  WOMEN 

not  necessary  to  have  the  air  confined.  In  this  form  of 
light  bath  the  body  is  directly  exposed  to  the  effects  of 
radiant  light  and  heat. 

The  incandescent  electric-light  bath  is  superior  to  every 
other  form  of  heating  procedure  in  which  the  only  object  is 
the  preparation  for  the  cold  bath.  The  time  required 
is  not  more  than  from  three  to  five  minutes.  When  it  is 
desired  to  produce  profuse  perspiration,  the  patient  may 
remain  in  from  eight  to  fifteen  minutes.  A  longer  stay 
than  this  is  apt  to  produce  an  overstimulation  of  the 
nervous  system  and  an  excessive  elevation  of  tempera- 
ture. 

The  electric-light  bath  possesses  the  distinct  advantages 
that,  while  the  body  is  exposed  to  a  high  degree  of  heat, 
the  air  of  the  room  in  which  the  head  is,  and  which  one 
is  breathing,  may  be  cool,  and  unique  advantages  in  the 
exactness  of  the  dosage  as  regards  time  and  intensity. 
It  can  also  be  used  in  a  much  greater  number  of  diseases 
than  the  hot-air  room  of  the  Turkish  bath. 

The  finishing  treatment  on  leaving  the  cabinet  is  iden- 
tically the  same  as  that  for  the  ordinary  Turkish  bath. 

Indications  for  Its  Use. — While  the  electric-light  bath 
is  not  a  complete  substitute  for  sweating  produced  by 
exercise,  it  comes  nearer  to  that  than  any  other  heating 
procedure,  and,  when  followed  by  some  vigorous  cold 
application,  it  possesses  a  hygienic  value  which  cannot  be 
overestimated. 

It  is  especially  valuable  in  cardiac  disease  and  diabetes. 
It  stimulates  oxidation,  and  is  thus  valuable  in  obesity 
and  the  toxemia  of  chronic  dyspepsia;  also  in  malarial 
cachexia,  syphilis,  neuritis,  neuralgia,  sciatica,  habit 
chorea,  hysteria,  rheumatism,  and  anemia. 

It  is  superior  to  all  other  treatment  in  chronic  rheuma- 
tism and  all  diseases  dependent  on  uric-acid  diathesis  or 
diminished  metabolism,  by  the  combined  action  of  the 
elevation  of  temperature  and  the  vigorous  cutaneous 
activity.  The  elevated  temperature  stimulates  the  oxida- 
tion of  the  proteid  wastes  and  augments  vital  combustion, 


HYDROTHERAPY  37 

while  the  increased  skin  activity  carries  off  all  waste- 
products  prepared  for  elimination. 

As  a  prophylactic,  this  form  of  bath  is  especially  valu- 
able for  all  persons  leading  a  sedentary  life;  it  is  the  best 
substitute  for  exercise  in  the  open  air,  and,  where  there 
are  no  contraindications  to  its  use,  should  be  taken  once  a 
week. 

In  cases  of  obesity,  sweating  may  be  used  to  reduce  the 
weight ;  but,  in  order  to  obtain  the  best  effects,  it  must  be 
combined  with  exercise,  and  it  must  be  borne  in  mind, 
that  in  obesity  there  is  great  danger  of  overheating  the 
blood,  in  consequence  of  the  obstacles  to  heat  elimination 
presented  by  the  thick  layers  of  non-conducting  fat.  There- 
fore, these  hot  applications  for  the  reduction  of  fat  should 
never  be  too  much  prolonged,  and  the  bath  should  always 
be  finished  by  vigorous  applications  of  cold.  These 
cold  applications  have  also  a  tonic  effect  upon  the  nervous 
system,  and  increase  the  muscular  disposition  for  exercise, 
and  this  is  the  most  rational  treatment  for  obesity. 

Loss  of  Weight. — There  are  many  cases  in  which  metabo- 
lism has  been  so  sluggish,  allowing  an  accumulation  of 
imperfectly  oxidized  matters  in  the  body,  that  the  first 
active  stimulation  of  the  nutritive  processes  is  in  dis- 
proportion to  the  increased  destructive  metabolism. 
Under  these  circumstances  there  is  necessarily  a  decrease 
in  weight.  The  rubbish  must  first  be  removed  and 
old  defective  structures  before  new  and  highly  organized 
tissues  can  be  deposited.  A  slight  loss  of  weight  need, 
therefore,  give  rise  to  no  apprehension,  but  if  the  loss  is 
considerable,  or  continues  for  some  time,  especially  if 
accompanied  by  loss  of  strength  or  appetite,  it  is  a  matter 
for  investigation. 

Palpitation  of  the  heart  and  fulness  of  the  head  are  an 
indication  that  the  applications  have  been  too  hot  or  too 
long  continued.  Vertigo  and  fainting  are  apt  to  occur 
when  hot  applications  have  been  continued  too  long,  but 
they  are  quickly  relieved  by  cold  applications,  especially 
by  cold  affusions  to  the  chest  and  shoulders.     Headache 


38         PERSONAL  HYGIENE  FOR  WOMEN 

may  result,  either  from  excessively  hot  or  cold  procedures. 
Deficient  reaction  is  generally  the  result  of  a  too  prolonged 
application  of  cold. 

On  entering  the  electric-light  cabinet,  a  wet  towel 
wrung  out  of  ice-water  is  placed  around  the  neck  and 
another  around  the  forehead ;  or  an  ice-bag  may  be  placed 
on  the  top  of  the  head. 

The  Douche. — A  douche  consists  of  a  single  or  multiple 
column  of  water  directed  against  some  portion  of  the  body. 
The  apparatus  is  complicated,  and  it  is  essential  that  an 
accurate  pressure-gauge  and  thermometer  should  be  intro- 
duced into  the  circuit  of  the  douche.  It  can  only  be 
properly  administered  in  a  hydriatic  establishment.  In 
the  employment  of  the  douche  three  factors  must  be  con- 
sidered— the  temperature,  pressure,  and  the  mass. 

The  range  of  temperature  employed  varies  from  45° 
to  125°  F.  The  pressure  ordinarily  employed  varies  from 
10  to  60  pounds.  The  mass  varies  according  to  the  effect 
desired,  and  may  be  regulated  by  means  of  the  finger, 
placed  in  the  water  column  near  the  nozzle. 

The  douche  is  applied  by  means  of  the  rubber  hose, 
which  is  connected  at  its  proximal  end  with  the  water- 
supply,  and  at  its  distal  end  is  attached  a  nozzle,  the 
average  diameter  of  which  varies  from  2  inches  to  f  inch. 
From  these  a  fine  or  coarse  jet  or  a  fan  douche  may  be 
produced.  The  latter  is  formed  by  placing  the  index- 
finger  of  the  hand  holding  the  nozzle  upon  the  lower  bor- 
der of  the  outlet,  producing  an  expansion  of  the  otherwise 
solid  jet  into  a  fan-shaped  stream. 

The  mechanical  effects  of  the  douche  are  derived  from 
atmospheric  pressure,  and  this  is  of  more  importance  in  the 
effects  produced  than  the  temperature. 

The  Scotch  douche  consists  of  alternate  streams  of  hot 
and  cold  water.  The  general  cold  douche  is  the  most 
powerful  of  all  the  tonics;  the  warm  or  neutral  douche  is 
sedative;  the  very  hot  douche  is  frequently  followed  by 
atonic  reactions. 

The  Percussion  Douche. — This  is  the  form  of  douche 


HYDROTHERAPY  39 

most  frequently  used  in  the  hydriatic  establishments  of 
France,  In  this  there  is  a  combination  of  air  and  water, 
in  such  a  manner  that  the  column  of  water  is  broken  up 
into  a  number  of  short  columns,  and  projected  upon  the 
surface  of  the  skin  with  any  desired  amount  of  force.  The 
impression  produced  upon  the  skin  may  be  compared  to  a 
stream  of  lead  bullets  from  a  Gatling  gun,  and  is  accom- 
panied by  a  strong  tingling  of  the  skin. 

Not  only  are  the  blood-vessels  of  the  skin  made  to  con- 
tract, but  the  force  of  the  impact  compresses  the  tissues 
and  forces  the  blood  out  of  the  vessels,  leaving  them  free 
to  dilate  again  as  soon  as  the  pressure  is  removed.  Thus 
the  tissues  are  alternately  compressed  and  released;  in 
other  words,  a  veritable  massage  is  produced,  whereby 
the  circulation  is  excited  and  accelerated  and  the  thermic 
effects  of  the  douche  materially  aided  by  the  purely 
mechanical  or  percussion  effects  of  the  moving  water, 
as  really  as  if  friction  or  percussion  had  been  effected  by 
the  hand. 

Under  the  influence  of  this  douche,  and  the  only  other 
one  comparable  in  its  good  effects,  is  the  Scotch  douche; 
the  whole  organism  is  aroused  to  the  highest  degree  of 
activity,  the  vital  resistance  is  increased,  the  digestive 
activity  is  augmented,  oxidation  and  elimination  are 
increased;  all  the  wheels  of  hfe  move  with  quickened 
vigor,  and  the  individual  lives  on  a  higher  plane,  physically, 
mentally,  and  morally. 

Application  of  the  Douche.- — Since  in  France  the  most 
careful  scientific  study  has  been  made  of  all  hydriatic 
procedures,  and  all  the  establishments  there  are  under 
the  direction  of  physicians,  the  douche  will  be  described 
as  given  there. 

No  patient  at  any  of  the  cures  there  is  allowed  to  drink 
the  water  or  undertake  any  form  of  hydriatic  procedure 
without  first  being  carefully  examined  by  one  of  the  staff 
of  physicians  belonging  to  the  "cure.'^  After  this  ex- 
amination a  carefully  written  formula  is  given  the  patient 
for  the  instruction  of  the  attendant,  just  as  a  prescription 


40  PEESONAL  HYGIENE   FOR  WOMEN 

would  be  written  for  the  druggist.  On  this  card  is  written 
the  temperature  of  the  douche,  the  duration,  and  the  num- 
ber of  pounds  pressure  to  be  given. 

The  halls  and  dressing-rooms  of  these  establishments  are 
kept  much  cooler  than  in  this  country,  so  that  a  heavy 
dressing  govm  is  needed  to  go  from  the  dressing-room 
to  the  bath.  Straw  sandals  are  provided,  which  are  re- 
moved on  entering  the  douche  room.  The  hair  is  kept 
dry  by  means  of  a  iTibber  cap,  which  should  be  pulled 
down  well  over  the  ears. 

The  bather  is  first  directed  to  wash  her  face,  then  the 
jet  is  applied  first  to  the  back  for  a  few  seconds,  then  the 
legs  and  arms,  then  the  anterior  part  of  the  body  and  the 
liver,  ending  with  a  strong  dash  on  the  feet.  The  entire 
body  is  gone  over  in  this  way  several  times,  the  patient 
turning  around  as  directed  by  the  attendant.  The  patient 
stands  while  taking  the  douche;  if  she  is  feeble,  rails  are 
provided  to  lean  against. 

In  the  application  of  the  douche  it  must  be  remembered 
that  the  stream  of  water  must  not  be  allowed  to  fall  stead- 
ily upon  one  spot,  but,  by  constant  movements  of  the 
nozzle  and  the  body  of  the  patient,  the  stream  should  be 
directed  upon  different  portions  of  the  body  in  a  suc- 
cession of  dashes. 

The  hot  douche  is  most  frequently  used  as  a  preparation 
for  the  cold  one.  The  cold  douche  is  never  given  without 
some  sort  of  heating  process  as  a  preparation.  The  dura- 
tion of  the  cold  douche  is  from  three  to  four  seconds. 
The  temperature  of  the  cold  douche  is  from  45°  to  65°  F.; 
the  cool  douche  is  from  65°  to  80°  F. ;  the  tepid  douche,  80° 
to  92°  F.;  the  neutral  douche,  95°  to  97°  F.;  and  the  hot 
douche,  from  104°  to  125°  F. 

A  good  working  douche  is  between  55°  and  70°  F. 
The  higher  the  temperature,  the  longer  must  be  the 
duration  and  the  greater  the  pressure  required  to  produce 
the  tonic  effects. 

The  neutral  douche  should  be  given  with  a  pressure  of 
from  5  to  20  pounds,  and  a  duration  of  from  three  to  fifteen 


HYDROTHERAPY  41 

minutes;  but,  if  a  sedative  effect  is  desired,  the  pressure 
should  not  exceed  10  pounds. 

After  the  douche  the  patient  is  enveloped  in  a  hot  sheet, 
over  which  the  bath-robe  is  thrown,  the  sandals  are  again 
put  on,  and  the  patient  returns  to  her  dressing-room, 
where  she  is  vigorously  rubbed  down  by  the  attendant 
through  the  sheet,  the  patient  herself  assisting  in  the 
drying  process  by  the  use  of  hot  towels.  After  this,  the 
attendant  goes  over  the  entire  body  with  her  hand  cov- 
ered by  a  coarse  hair  glove,  and  very  many  pounds  pres- 
sure, untU  the  whole  body  is  in  a  glow.  If  the  reaction  is 
not  as  prompt  as  should  be,  the  attendant  uses  her  bare 
hand. 

This  douche  should  not  be  taken  sooner  than  two  hours 
after  meals.  The  best  time  of  day  is  about  10  o'clock 
in  the  morning  or  3  in  the  afternoon. 

Rationale  of  the  Douche. — The  douche  is  a  thermic 
massage.  Since  the  douche  is  a  sorbefacient  of  pathologic 
products,  the  French  have  availed  themselves  of  its  use  to 
aid  the  body  to  throw  off  an  excess  of  uric  acid,  fatigue 
toxins,  etc. 

It  has  been  demonstrated  that  a  rain  douche  of  50°  F., 
under  a  pressure  of  two  atmospheres,  increases  threefold 
the  work  that  the  muscles  are  capable  of  doing,  while 
the  Scotch  douche,  oscillating  between  98°  and  53°  F., 
doubles  the  working  capacity  of  the  muscles.  Even  tepid 
douches  increase  the  working  capacity  of  the  muscles, 
while  a  tub-bath  of  the  same  temperature  is  without  decided 
effect.  The  pressure  under  which  the  douche  is  given 
adds  a  powerful  element,  which  is  absent  in  other  hydriatic 
procedures.  The  percussion  and  vibration  affect  the 
vasomotor  system  much  more  powerfully  than  any  form 
of  stUl  bathing. 

The  power  and  action  of  the  heart  are  greatly  improved 
by  the  use  of  the  douche,  the  capacity  of  the  lungs  is  in- 
creased, and  the  digestion  is  improved. 

Brief  douches  of  from  ten  to  fifteen  seconds  generally 
act  better  than  those  of  longer  duration.    The  general 


42  PERSONAL   HYGIENE   FOR   WOMEN 

condition  of  the  patient  must  always  be  carefully  studied, 
and,  like  the  Turkish  bath,  the  douche  should  always  be 
taken  under  the  direction  of  a  physician,  as  they  are  also 
capable  of  doing  a  great  amount  of  harm  as  well  as  good. 
The  best  results  from  the  douche  are  obtained  when  it  is 
taken  following  the  use  of  the  electric-light  bath. 

The  neutral  douche  is  particularly  applicable  in  cardiac 
affections  and  in  cases  of  high  arterial  tension.  The 
sensation  afforded  should  not  be  either  that  of  hot  or  cold, 
and  the  duration  from  one  to  two  minutes.  The  douche 
for  this  purpose  should  be  given  with  only  a  slight  degree 
of  pressure,  and  to  avoid  irritation  it  should  be  directed 
to  either  side  of  the  spinal  column.  This  is  a  sedative 
application. 

Contraindications  for  the  Use  of  the  Douche. — In  all 
acute  inflammations  and  in  eruptive  disorders  of  the  skin. 
The  cold  douche  is  contraindicated  in  inflammation  of  the 
uterus,  ovaries,  kidneys,  stomach,  liver,  bowels,  and 
bladder,  in  intestinal  catarrh,  chronic  inflammation  of  the 
stomach,  and  general  neuritis.  It  must  also  be  avoided 
in  rheumatism,  arteriosclerosis,  cardiac  insufficiency, 
valvular  diseases  of  the  heart  with  deficient  compensation, 
fatty  degeneration  of  the  heart,  and  in  cases  of  extreme 
nervous  irritability. 

The  Internal  Use  of  Water. — The  internal  use  of 
water  is  essential  to  life.  Water  constitutes  about  two- 
thirds  of  the  body  weight ;  it  is  found  in  every  tissue  and 
organ  of  the  body;  it  acts  to  dilute  the  foods  so  that  they 
can  be  absorbed  from  the  digestive  tract ;  its  presence  in  the 
blood  is  essential,  both  to  carry  foods  to  the  tissues  and  to 
convey  the  waste  matter  away  from  the  tissues.  Its  use 
in  the  form  of  a  lavage  is  even  more  necessary,  to  keep 
clean  and  free  from  impurities  the  mucous  membrane 
lining  the  30  feet  of  the  digestive  canal  and  the  tubules  of 
the  kidneys  than  is  the  external  use  of  water  to  keep 
the  skin  in  a  healthy  condition.  Its  use  is  also  needed 
to  keep  the  blood-pressure  and  the  heart  in  a  normal 
condition. 


HYDROTHERAPY  43 

About  4§  pints  of  water  are  given  off  daily  in  tlie  excreta 
and  exhalations;  but,  since  about  one-half  of  the  solid 
foods  taken  consist  of  water,  3  pints  of  water,  taken  daily 
as  such,  are  sufficient  to  counterbalance  the  loss. 

All  water  for  drinking  purposes  should  be  filtered.  The 
best  method  is  to  have  a  filter  attached  to  the  pipes  of  the 
house-supply,  so  as  to  insure  filtered  water  running  from 
all  the  spigots. 

If  the  water  is  not  filtered,  it  should  be  boiled  for  thirty 
minutes.  The  water  should  be  run  off  in  the  morning, 
then  poured  into  a  well-kept  tea-kettle  and  boiled.  It  is 
then  allowed  to  stand  and  become  partially  cooled  in 
covered  vessels,  when  it  is  poured  into  large  bottles — 
quarts  are  the  most  convenient  size;  these  should  be  stop- 
pered with  corks  of  absorbent  cotton.  When  cool,  the 
bottles  are  placed  in  the  refrigerator  beside  the  ice. 
Water  should  be  boiled  every  morning  for  the  twenty- 
four  hours.  Boiling  for  this  length  of  time  secures  the 
destruction  of  all  the  germs  of  disease,  and  it  is  doubly 
essential  on  the  return  to  town  in  the  fall,  when  the  house 
has  been  closed  for  some  time ;  also  when  typhoid  fever  in 
the  neighborhood  indicates  the  strong  possibility  of  the 
impurity  of  the  water-supply. 

The  mistake  should  not  be  made  of  undoing  the  good 
that  has  been  done  by  boiling  the  water  by  the  addition  of 
ice  to  the  water  when  it  is  placed  on  the  table.  Further- 
more, ice-water  is  so  cold  that  it  retards  and  interferes 
with  the  digestive  processes. 

In  the  internal  use  of  water  the  same  marked  difference 
is  caused  by  the  different  temperatures  at  which  the 
water  is  taken,  as  was  seen  in  the  external  applications  of 
water;  but,  while  the  tem^perature  of  the  skin  is  about  90° 
F.,  that  of  the  mucous  membrane  lining  the  digestive 
tract  is  98.6°  F.  and  above. 

The  Action  of  the  Internal  Use  of  Water  on  the  Heart  and 
Blood. — Water  improves  the  quality  of  the  blood,  both  by 
its  direct  action  on  the  constituents  and  by  the  increased 
elimination  of  waste-products.      By  the  increase  of  the 


44         PERSONAL  HYGIENE  FOR  WOMEN 

volume  of  blood,  a  more  energetic  contraction  of  the  heart 
is  caused,  and  the  activity  of  all  the  glands  of  the  body  is 
increased.  There  is  a  greater  amount  of  oxygen  absorbed 
by  the  lungs;  oxidation  in  the  tissues  is  carried  on  more 
perfectly,  the  result  of  which  is  that  there  is  a  diminution 
or  absence  of  the  products  of  incomplete  combustion  in  the 
body,  such  as  uric  acid,  the  oxalates,  etc. 

By  the  increase  of  the  blood-pressure,  caused  by  drink- 
ing water  in  sufl&cient  quantities,  the  activity  of  the  kid- 
neys is  increased,  and  this  not  only  in  the  amount  of  urine 
passed,  but  also  of  the  solid  constituents,  which  are  the 
waste-products,  removed  from  the  body  through  the 
agency  of  the  kidneys. 

The  Action  of  Water  on  the  Digestion. — Very  little  water 
is  absorbed  from  the  stomach ;  it  passes  from  the  stomach 
to  the  intestines,  where  it  is  absorbed.  In  order  to  ob- 
tain a  thorough  cleansing  of  the  stomach,  and  at  the 
same  time  not  to  cause  its  overdistention,  not  less  than 
I  pint  of  water  and  not  more  than  IJ  pints  should  be 
taken  at  one  time.  The  water  must  be  taken  one  hour 
before  meals,  in  order  to  insure  its  removal  from  the  stom- 
ach and  the  proper  rest  of  that  organ  before  food  enters 
it,  as  it  has  been  found  by  actual  experiment  that  in  a 
quarter  of  an  hour  after  water  had  been  taken  one-half 
of  the  quantity  remained  in  the  stomach,  but  that  none 
remained  after  the  lapse  of  half  an  hour.  Cold  water  is 
more  quickly  absorbed  than  warm,  and  the  absorption 
is  hastened  by  the  presence  of  carbonic  acid,  while  salt  of 
any  kind  delays  its  absorption. 

The  Therapeutic  Indications  for  the  Use  of  Water. — 
First,  the  temperature  of  the  water  taken  must  be  regu- 
lated by  the  effect  desired.  Briefly  stated,  if  the  water 
is  taken  for  dyspepsia  in  any  form,  whether  acute  or 
chronic  catarrhal  inflammation  of  the  stomach  or  the 
intestinal  canal,  f  pint  of  water,  just  as  hot  as  it  can  be 
sipped  with  a  spoon,  should  be  taken  three  times  a  day, 
one  hour  before  each  meal. 

No  water  should  be  taken  during  the  meal,  and  only 


HYDROTHERAPY  45 

one  glass,  at  a  temperature  of  about  60°  F.,  on  its  com- 
pletion. 

If  the  water  is  taken  as  a  diuretic,  or,  in  other  words, 
to  increase  the  activity  of  the  kidneys,  the  most  of  the 
water  should  be  taken  in  the  morning  on  rising  and  the 
remainder  about  4  o'clock  in  the  afternoon.  Probably 
the  best  natural  waters  for  this  purpose  are  the  waters  of 
the  Vosges,  France.  The  Vittel  water,  '^  Grande  Source," 
acts  on  the  kidneys  alone;  where  the  bowels  are  regular 
or  inclined  to  be  loose,  this  is  the  best  water  to  use.  If, 
on  the  contrary,  there  is  constipation  or  biliousness,  the 
"Source  Salee"  should  be  taken  in  connection  with  the 
first  named  or  alone.  The  "  Source  Salee  "  has  a  decided 
action  on  the  liver  and  is  laxative. 

In  order  to  obtain  a  pronounced  effect,  at  least  3  pints 
of  these  waters  should  be  taken  daily;  in  some  cases  more 
is  required.  Two  glasses  may  be  taken  on  rising  in  the 
morning,  with  an  interval  of  twenty  minutes  between; 
the  last  glass  must  be  taken  one  hour  before  breakfast. 
The  temperature  of  the  water  should  be  50°  F.,  which  is 
the  temperature  of  the  water  at  the  springs  and  that  of  the 
water  when  placed  in  bottles  in  the  refrigerator  against 
the  ice.  In  the  afternoon  the  other  two  glasses  may  be 
taken,  with  the  same  interval  between. 

In  gastric  catarrh,  where  there  is  an  accumulation  of 
mucus  or  fermenting  matter,  with  or  without  nausea  and 
vomiting,  hot  water  alone  is  useful.  In  addition  to  its 
action  in  diluting  the  contents  of  the  stomach  and  the 
intestines,  and  its  cleansing  and  antiseptic  effect  on  their 
mucous  membranes,  the  reflex  effect  of  very  hot  water, 
slowly  sipped,  is  a  stimulation  of  their  muscular  coats, 
which  furthers  the  passage  of  the  digested  food  from  the 
stomach  into  the  intestines.  The  quantity  taken  must 
be  from  J  to  1  pint,  in  order  to  obtain  a  thorough  cleansing 
and  yet  not  to  cause  an  overdistention  of  the  stomach. 

In  acute  nephritis,  inflammation  of  the  kidneys,  small 
quantities  of  very  cold  water,  repeated  at  half-hourly 
intervals,  act  as  a  diuretic.    Care  must  be  had,  however, 


46  PERSONAL  HYGIENE   FOR  WOMEN 

not  to  overtax  the  stomach  and  heart  by  overfilling 
the  system  with  fluids. 

In  obesity,  water-drinking  is  essential  as  a  means  of  dis- 
solving and  carrying  out  of  the  body  the  large  amount  of 
broken-down  material  which  results  from  the  increased 
tissue  destruction  caused  by  exercise,  hot  and  cold  baths, 
and  other  means  employed  to  decrease  the  weight. 

For  constipation  and  biliousness  two  glasses  of  cold 
vv^ater  should  be  taken  before  breakfast,  with  an  interval 
of  twenty  minutes  between,  the  last  glass  being  taken 
one  hour  before  breakfast. 

Contraindications. — Cold  water  taken  into  the  stomach 
produces  more  marked  effects  than  water  applied  to  an 
equal  area  of  the  skin.  The  quantity  of  water  taken  is 
a  factor  as  well  as  the  temperature.  Cold-water  drinking 
lowers  the  temperature  and  slows  the  pulse,  so  that  drink- 
ing cold  water  must  be  strictly  prohibited  when  one  is 
in  a  state  of  fatigue,  whether  perspiring  or  not.  Feeble 
persons  should  not  drink  cold  water,  except  in  very  hot 
weather,  or  just  before  starting  out  for  a  brisk  walk  in  the 
open  air,  or  when  about  to  engage  in  other  exercise.  With 
the  air  of  the  room  at  70°  F.,  a  woman  in  fair  condition, 
moving  about  making  her  toilet,  may  safely  drink  cold 
water  slowly,  except  when  there  is  a  feeling  of  chilliness. 
In  the  latter  case,  the  powers  of  reaction  being  diminished, 
chill  and  internal  congestion,  often  resulting  in  great 
injury,  may  be  produced.  Cold-water  drinking  is  always 
prohibited  when  in  a  state  of  fatigue.  Ice-water  should 
never  be  taken.  When  taken  with  meals,  it  greatly 
retards  digestion  and  may  do  much  harm. 

The  French  Cures  of  the  Vosges. — Six  hours  east  from 
Paris,  situated  in  the  foot-hills  of  the  Vosges  mountains, 
at  an  elevation  of  from  1 100  to  1200  feet,  are  three  of  the 
noted  French  cures — Vittel,  Contrexeville,  and  Martigny- 
les-Bains.  Their  waters  are  very  similar,  those  of  Vittel 
being  the  mildest  and  those  of  Martigny-les-Bains  the 
m-ost  powerful,  but  at  all  of  them  the  drinking  of  the 
waters  is  the  main  thing,   supplemented  by  hydriatic 


HYDROTHERAPY  47 

procedures.  Contrexeville  is  the  oldest  and  best  known; 
Martigny-les-Bains  has  the  best  natural  location  and  is 
the  newest.  Vittel  has  the  advantage  of  having  first- 
class  hotels  and  an  ideal  hydrotherapeutic  establish- 
ment, equipped  with  all  the  modem  contrivances  for 
mechanotherapy  and  every  known  form  of  douche. 

The  manner  of  drinking  the  water  is  the  same  in  all, 
the  difference  being  in  the  quantity  of  water  taken,  which 
varies  with  its  strength. 

At  all  there  are  only  two  meals  a  day,  breakfast  being 
omitted;  the  "  dejeuner  a  lafourchette,"  at  ten  or  half  after, 
corresponds  to  our  luncheon,  except  that  it  is  much  heav- 
ier.    Dinner  is  served  at  half  after  six. 

On  reaching  the  ''Cure"  the  patient  at  once  selects  her 
physician,  and  places  herself  under  his  care  during  her 
stay.  She  is  subjected  to  a  most  careful  examination, 
and  closely  watched  to  ascertain  the  effects  of  the  waters 
and  other  procedures  ordered. 

The  drinking  establishment  is  in  the  Park,  and  patients 
are  expected  to  reach  there  at  7  o'clock  in  the  morning. 
On  the  first  morning  of  the  cure  only  two  glasses  of  water 
are  taken;  the  size  of  the  glass  varies  from  J  to  1  liter, 
according  to  the  condition  of  the  patient.  The  water 
is  taken  at  the  temperature  at  which  it  comes  from  the 
springs,  namely,  50°  F.,  as  this  is  a  much  greater  tonic  to 
the  digestive  organs  and  the  kidneys  than  warm  water. 
The  water  is  taken  slowly,  the  patient  moving  about  while 
drinking  it.  After  this  a  brisk  walk  of  twenty  minutes 
through  the  park  is  ordered,  when  the  patient  returns  to 
the  pavillion  for  her  next  glass  of  water.  The  walk  is 
then  resumed,  and  great  emphasis  is  laid  on  the  rule  not  to 
eat  anything  for  one  hour  after  drinking  the  last  glass  of 
water.  The  reason  for  this  is  obvious.  The  water  is 
given  in  such  quantity  as  to  cause  a  laxative  action,  the 
object  being  to  secure  a  complete  lavage  of  the  gastro- 
intestinal tract  when  completely  empty,  so  as  not  to  inter- 
fere or  carry  off  the  products  of  digestion.  Several  watery 
stools  are  produced,  the  last  one  not  being  later  than  10 


48  PERSONAL  HYGIENE   FOR   WOMEN 

o'clock  in  the  morning;  any  stool  after  this  hour  is  con- 
sidered in  the  light  of  a  diarrhea  and  is  so  treated. 

At  4  o'clock  in  the  afternoon  another  glass  is  taken. 

On  the  second  day  three  glasses  are  taken  in  the  morn- 
ing and  two  in  the  afternoon,  always  with  an  interval  of 
twenty  minutes  between.  On  the  third  day  four  glasses 
are  taken  in  the  morning  and  two  in  the  afternoon.  This 
is  the  maximum  quantity  taken  at  Contrexeville;  and  this 
quantity  of  water  is  taken  every  day  during  the  cure, 
except  that  at  the  last  three  days  there  is  the  same  tapering 
off  in  the  amount  of  water  taken  as  was  observed  at  the 
beginning.     The  time  of  the  cure  is  three  weeks. 

At  first  the  lack  of  the  accustomed  breakfast  feels  like 
a  great  hardship,  and  if  the  patient  is  not  very  vigorous, 
she  is  apt  to  feel  exhausted ;  but,  with  the  bracing  morning 
air,  the  exhilaration  of  the  brisk  exercise,  the  lively  music 
of  a  really  excellent  band,  and  the  interest  of  the  moving 
panorama,  one  soon  becomes  accustomed  to  the  changed 
routine. 

The  elevation,  the  great  purity  of  the  air  of  these  pine 
forests,  the  entire  change  of  scene,  and  the  freedom  from 
care  doubtless  all  contribute  to  the  benefits  effected  by 
these  cures,  but  the  substantial  and  very  salutary  after- 
effects can  only  be  attributed  to  the  ridding  of  the  body 
of  a  large  amount  of  toxins,  and  to  the  greater  activity  of 
all  the  digestive  processes  and  of  the  general  body  metabo- 
lism. 

One's  faith  in  the  power  of  ozone  and  the  benefits  of 
early  morning  exercise  in  the  open  air  becomes  firmly 
fixed  as  she  feels  the  cobwebs  being  swept  out  of  her 
brain.  The  sensation  produced  is  that  of  a  current  of 
fresh  air  passing  through  the  brain  itself.  The  accom- 
panying feeling  of  well-being,  caused  by  the  increased 
activity  of  the  circulation  of  the  brain,  is  indescribably 
delightful. 

On  leaving  the  cure  the  patient  is  advised,  on  returning 
home,  to  drink  the  water  one  week  out  of  every  month — 
preferably  the  week  following  the  menstrual  period. 


HYDROTHERAPY  49 

Enemas. — Coloclysters. — Another  valuable  internal 
use  of  water  is  for  emptying  the  lower  bowel,  and  washing 
out  the  large  bowel  in  cases  of  catarrhal  inflammation. 

For  constipation,  in  which  the  object  is  to  unload  the 
bowel  as  quickly  as  possible,  1  or  2  pints  of  water,  at  a 
temperature  of  from  104°  to  110°  F.,  is  made  into  a  suds 
by  means  of  Castile  or  other  good  soap,  and  poured  into 
a  fountain-syringe.  If  the  enema  is  being  given  by  an 
attendant,  the  patient  lies  on  the  right  side  in  the  Sims' 
position;  the  under  leg  is  stretched  out  so  that  it  forms 
a  straight  line  with  the  trunk,  while  the  upper  leg  is  sharply 
flexed  at  the  knee,  so  that  the  foot  is  opposite  the  knee 
of  the  under  leg;  the  right  arm  is  thrown  back  from  under 
the  body. 

If  the  patient  is  administering  the  enema  to  herself, 
the  best  position  is  the  knee-chest.  In  this  the  patient 
kneels  on  the  floor,  the  thighs  are  held  rigid,  and  while  the 
shoulders  are  brought  to  touch  the  floor,  the  face  is  turned 
to  one  side.  The  position  can  only  be  taken  satisfactorily 
with  the  corsets  and  all  tight  bands  around  the  waist 
removed.  In  this  position  gravity  causes  the  intestines 
to  fall  upward  toward  the  waist,  and  the  water  naturally 
follows  this  course.  In  this  position  the  water  goes  up 
higher,  and  is  retained  longer,  than  when  taken  in  the 
other  positions.  Two  pints  of  the  soap-suds  are  prepared 
at  the  proper  temperature,  and  the  patient  uses  as  much 
of  this  as  she  feels  that  she  can  retain.  The  water  should 
be  retained  from  five  to  ten  minutes,  to  get  the  best  results. 

For  the  purpose  of  washing  out  the  large  intestine  more 
water  is  used,  but  not  more  than  2  quarts  should  be  used 
for  this.  The  position  of  the  patient  and  the  temperature 
of  the  water  are  the  same.  But  for  this  clyster,  instead  of 
adding  soap  to  the  water,  cooking  salt  is  used,  in  the 
proportion  of  1  teaspoonful  of  salt  to  1  pint  of  water. 

This  lavage  of  the  intestine  removes  rapidly  large  masses 
of   decomposing  material,  swarming  with  microbes  and 
ptomains   and   the   toxins  produced  by  them.     It  also 
increases  the  activity  of  the  portal  circulation. 
4 


50  PERSONAL  HYGIENE   FOR  WOMEN 

In  cases  of  chronic  constipation  there  are  atony  and 
dilatation  of  the  colon,  and  the  patient  always  carries 
about  with  her  an  enormous  accumulation  of  fecal  matter, 
and  lives  in  a  state  of  chronic  autointoxication.  In  this 
class  of  cases  the  coloclyster  should  be  administered  daily 
for  from  two  to  three  weeks;  if  need  be,  so  long  as  the 
patient  complains  of  gaseous  distention  and  fetid  flatu- 
lence. After  the  discharge  of  the  warm  water,  1  pint  of 
cool  water  should  be  introduced,  beginning  with  a  tem- 
perature of  85°  F.,  and  gradually  decreasing  this  from 
day  to  day  until  70°  F.  is  reached.  This  water  should 
be  retained  if  possible;  it  acts  as  a  tonic  bath  for  the  colon. 

Gare  should  be  exercised  to  avoid  the  distention  of  the 
colon  by  an  excessive  amount  of  water,  and,  after  the 
colon  has  been  thoroughly  cleansed,  the  amount  of  water 
used  should  be  decreased  from  day  to  day,  until  finally 
only  1  pint  is  used.  Warm  water  is  always  relaxing, 
whereas  cold  water  stimulates  and  tones  up  the  bowel. 
If  the  quantity  of  water  used  is  smaU,  the  cold  coloclyster 
may  be  used  indefinitely  without  producing  constipating 
effects. 

Great  care  must  be  used  to  avoid  the  introduction  of  air 
into  the  bowel  with  the  water;  to  this  end  the  water  is 
allowed  to  run  out  of  the  nozzle  before  its  introduction 
into  the  rectum.  A  small-sized  nozzle  should  always  be 
used,  and  this  should  be  lubricated  with  vaselin  or  some 
other  emollient,  in  order  to  prevent  irritation  of  the  mucous 
membrane. 

Vaginal  Irrigations. — To  be  of  any  service  the  vaginal 
douche  should  be  taken  in  the  horizontal  position.  It 
may  be  taken  on  the  bed,  couch,  or  lying  on  the  floor. 
When  taken  on  the  floor,  a  heavy  rug  or  steamer  blanket 
should  be  doubled  four  times,  and  two  pillows  are  used: 
the  under  one  goes  up  and  down  for  the  support  of  the 
back,  while  the  second  is  used  for  the  support  of  the  head. 
A  douche-pan  is,  of  course,  indispensable.  The  agate  pans 
holding  4  quarts  of  water  are  the  most  serviceable.  The 
douche-pan  is  placed  against  the  lower  edge  of  the  under 


HYDROTHERAPY  51 

pillow,  which  is  protected  by  a  bath-towel.  The  woman 
must  throw  a  heavy  shawl  or  blanket  over  herseM  while 
taking  the  douche,  otherwise  there  is  great  danger  of 
becoming  chilled,  and  thus  doing  actual  harm  instead  of 
good. 

The  most  common  and  best  form  of  syringe  is  the  foun- 
tain-syringe. This  is  himg  about  6  feet  above  the  bed  or 
floor.  It  should  hold  4  quarts  of  water;  this  quantity  of 
water  is  necessary  when  the  douche  is  given,  as  it  most 
commonly  is,  for  pelvic  inflammation.  On  beginning 
its  use,  the  temperature  of  the  water  must  be  controlled 
by  the  sensitiveness  of  the  patient;  generally  one  can  use 
a  temperature  of  at  least  112°  F.,  but  not  always;  some- 
times one  must  be  content  with  a  beginning  temperature 
as  low  as  104°  F.,  gradually  increasing  the  temperature  by 
two  degrees  every  few  da3^s,  until  from  114°  to  120°  F.  is 
reached.  The  use  of  a  bath  thermometer  is  always  essen- 
tial to  test  the  temperature  of  the  water.  The  tempera- 
ture of  the  douche  should  never  go  above  120°  F.,  or 
actual  harm  will  be  done. 

On  lying  down,  the  lower  part  of  the  body  rests  on  the 
broad  strip  of  the  douche-pan,  the  nates  coming  over  the 
edge,  and  the  clothing  well  pushed  up,  otherwise  the 
water  will  seep  up  the  back. 

The  water  acts  as  a  hot  poultice  about  the  uterus  and  its 
adnexa;  it  is  also  astringent,  and  greatly  reHeves  ovarian 
irritation  and  congestion.  It  is  highly  sedative,  and  is 
best  used  at  night  just  before  retiring.  In  severe  cases 
better  results  will  be  obtained  by  its  use  twice  daily.  In 
that  case  one  douche  must  be  taken  in  the  morning,  but 
in  cold  weather  it  must  never  be  taken  immediately 
before  going  out-of-doors;  there  must  be  at  least  one  hour 
between  the  time  of  taking  the  douche  and  going  out  into 
the  cold  air.  Patients  taking  hot  douches  must  be 
warned  that  the  pelvic  viscera  are  much  more  susceptible 
of  chiUing  because  of  these  heating  procedures,  and  of  the 
necessity  to  counteract  this  tendency  by  the  wearing  of 
woolen  abdominal  bands,  both  night  and  day. 


52  PERSONAL  HYGIENE   FOR  WOMEN 

Ordinarily,  plain  hot  water  is  all  that  is  necessary 
to  use,  but  if  the  vaginal  discharge  is  irritating,  one  tea- 
spoonful  of  borax  may  be  added  to  the  pint  of  water;  or 
one  teaspoonful  of  cooking  salt;  or  one-half  teaspoonful 
of  the  sulphate  of  zinc. 

Douching  the  Ear. — This  procedure  is  made  use  of  to 
remove  impacted  ear-wax  or  to  relieve  the  pain  of  earache. 
A  small  fountain  syringe  should  be  used,  hung  not  more 
than  3  feet  above  the  head.  The  water  should  have  a 
temperature  of  from  105°  to  110°  F.  The  nozzle  must 
be  small,  and  have  a  very  fine  opening,  and  great  care 
must  be  used  in  its  introduction  not  to  allow  the  nozzle 
to  enter  beyond  the  external  opening  of  the  ear.  A  pus- 
basin  or  small  dish  may  be  used  to  protect  the  clothing 
from  getting  wet.  After  the  procedure  is  finished,  the 
ear  is  dried  by  means  of  a  very  fine  handkerchief  or  a 
little  absorbent  cotton. 


CHAPTER  II 

THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES 

The  Complexion;  the  Action  of  the  Bath  in  Health;  the  Proper 
Time  to  Bathe;  the  Care  of  Wash-cloths;  Cleansing  the  Face;  Pro- 
tection of  the  Face;  the  Use  of  So-called  Cosmetics  for  the  Face; 
Facial  Blemishes,  Freckles,  Liver  Spots,  Sallow  Complexion,  Pim- 
ples, Acne,  Eczema,  Wrinkles,  and  Superfluous  Hair  and  Their 
Treatment;  the  Relation  of  Diseases  of  the  Skin  to  Internal  Disor- 
ders. 

The  Hair;  Dandruff;  Causes  and  Treatment  of  Premature  Thin- 
ness of  the  Hair  and  Baldness;  the  Care  of  the  Hair;  Gray  Hair._ 

The  Cosmetic  Care  and  Treatment  of  the  Hands;  Cosmetic  of 
the  Nails;  the  Care  of  the  Feet;  Painful  Affections  of  the  Feet. 

The  face  is  a  complete  index  of  the  life  of  the  individual 
written  large,  so  that  he  who  runs  may  read.  By  looking 
at  the  condition  of  the  skin  and  the  whites  of  the  eyes  we 
can  judge  very  fairly  of  the  digestion.  From  the  dulness 
or  brilliancy  of  the  eyes  we  can  make  a  very  good  diagnosis 
of  the  mental  condition.  From  the  general  expression  of 
the  face  we  can  read  the  kind  of  life  that  has  been  led  by 
the  individual,  whether  of  pleasure,  dissipation,  or  sorrow. 

From  greatest  antiquity  men  and  women  have  striven 
to  beautify  their  bodies.  To  be  indifferent  to  the  personal 
appearance  is  an  indication  of  some  abnormal  condition  in 
the  individual  or  her  environment. 

The  Complexion. — The  skin  of  the  face  is  known  as  the 
complexion,  and  this  is  the  part  of  the  skin  that  is  most 
exposed  to  the  vicissitudes  of  dust  and  grime  of  the 
streets  or  of  the  occupation,  as  well  as  to  heat,  cold,  and 
winds. 

An  ideal  complexion  combines  the  qualities  of  clearness, 
translucency,  and  fineness  of  the  outer  skin,  with  a  proper 
disposition  of  the  blood-supply. 

53 


54  PERSONAL   HYGIENE   FOR  WOMEN 

The  translucency  of  the  skin  may  reach  a  point  where 
it  becomes  an  absolute  defect,  as  is  sometimes  seen  in 
wasting  consumption. 

In  sickness  the  skin  becomes  dull,  opaque,  and  lusterless; 
with  returning  health,  its  proper  translucency  and  bril- 
liancy return. 

The  beauty  of  the  skin  is  evidence  of  good  respiration, 
good  digestion,  proper  excretion  by  the  bowels,  skin,  and 
kidneys,  good  condition  of  the  blood,  and  plenty  of  out- 
door exercise. 

It  is  now  well  known  that  the  skin,  as  well  as  other  parts 
of  the  body,  depends  for  its  integrity  upon  the  general 
nervous  system.  Disturbance  anywhere  in  the  body  acts 
upon  the  central  nervous  system.  A  simple  case  of  indi- 
gestion often  manifests  itself  over  considerable  areas  of  the 
skin. 

It  cannot  be  too  earnestly  impressed  on  the  reader  that 
beauty  is  entirely  dependent  on  the  health.  It  will 
readily  be  seen  that  no  external  applications  can  produce 
such  qualities  as  fineness  of  texture,  translucency,  and 
delicate  play  of  coloring  produced  by  the  contraction 
and  dilatation  of  the  blood-vessels. 

The  natural  order  in  which  to  consider  the  skin  will  be 
first  as  subservient  to  health,  and  then  as  it  is  conducive 
to  beauty. 

The  Action  of  the  Bath  in  Health. — Not  only  in  the 
art  of  pleasing,  but  in  the  maintenance  of  health,  neatness 
of  person  must  be  carried  to  perfection.  By  the  use  of 
friction,  soap  and  water,  the  scarf-skin  becomes  more  and 
more  constantly  renewed  by  the  layers  underneath  it. 
It  becomes  softer,  more  pliant,  and  finer  than  satin  in 
appearance  and  texture.  Besides  this,  as  has  already 
been  shown,  bathing  has  upon  the  corium  or  true  skin, 
and  thence  upon  the  general  system,  a  revitalizing  in- 
fluence. Combined  with  the  proper  kinds  of  soap, 
avoiding  the  use  of  irritating  ones,  bathing  removes  from 
the  skin  all  effete  oily  matters,  scales  of  the  scarf-skin, 
crusts,  the  saline  matters  excreted  by  the  perspiration, 


PLATE   I 


^ 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   55 

dust  of  all  kinds,  soot,  particularly  that  from  the  clothing, 
and  so  forth. 

Caustic  soaps  and  borax  in  excess  may  remove  the  oil 
in  so  great  quantities  as  to  be  detrimental  to  the  skin. 

Within  twenty-four  hours  the  skin,  especially  those 
parts  which  are  covered,  becomes  vested  with  a  pellicle 
of  impurities,  which,  when  allowed  to  remain,  become 
thicker  every  day,  and  may  produce  injurious  effects  by 
obstructing  the  excretory  openings  and  affording  lodge- 
ment for  disease.  The  effects  would  be  felt  not  only  in  the 
skin,  but  in  the  whole  organism.  The  skin  when  not 
cleansed  will  be  irritated  chemically  and  mechanically. 

The  Proper  Time  to  Bathe. — This  depends  on  the 
nature  of  the  bath  to  be  taken,  the  strength  of  the  woman, 
the  temperature  of  the  room,  and  the  season  of  the  year. 

To  repeat,  a  cold  bath  of  any  description  must  never 
be  taken  unless  the  body  has  a  decided  sensation  of 
warmth.  In  winter,  if  she  will  drink  a  glass  of  hot  water 
before  rising  and  has  a  warm  room,  the  woman  in  average 
health  may  take  a  cold  sponge  bath.  But  the  body  must 
be  very  gradually  trained  to  the  application  of  cold,  just  as 
it  is  to  vigorous  muscular  exercise.  For  the  woman  who 
has  never  in  her  life  taken  a  cold  bath  of  any  sort,  except 
in  midsummer,  to  begin  a  heroic  treatment  with  cold 
baths  in  winter  would  be  utter  folly,  which  might  easily  be 
the  cause  of  pneumonia  and  even  of  death.  The  time  to 
begin  a  systematic  use  of  cold  water  is  in  summer,  con- 
tinued through  the  autumn,  and  by  the  time  midwinter 
has  arrived,  the  system  has  become  so  toned  up  that  noth- 
ing but  good  can  result. 

If  the  woman  is  not  very  strong,  she  had  better  begin 
with  the  cold  ablutions,  just  to  the  waist,  on  rising  in  the 
morning.  These  must  always  be  followed  by  a  vigorous 
toweling  and  friction.  In  case  of  inflammation  of  the 
kidneys  or  pelvic  viscera,  cold  applications  to  the  abdomen 
should  be  avoided,  as  they  are  badly  borne. 

If  the  woman  is  anemic,  has  a  poor  circulation,  or  is  con- 
scious of  her  heart,  she  will  feel  at  her  best  in  the  after- 


56  PERSONAL  HYGIENE  FOR  WOMEN 

noon.  In  that  case,  after  a  cup  of  hot  bouillon,  taken 
on  rising  from  her  siesta,  she  may  take  a  quick  hot  scrub, 
followed  by  a  cold  shower.  This  is  much  more  invigorat- 
ing than  the  cold  ablution,  and  the  reaction  at  that  time 
of  the  day  is  more  vigorous  than  in  the  early  morning. 

From  the  simple  ablution,  the  next  step  in  training 
would  be  the  cold  wet  sheet.  It  is  impossible  to  take 
this  without  an  attendant,  but  a  good  maid  may  readily 
be  taught  to  give  the  necessary  rubbing.  Ordinarily, 
this  will  be  enough  to  attempt  in  one  winter. 

A  strong  woman,  who  has  always  been  accustomed  to 
taking  cold  baths,  may  all  the  year  round,  except  just 
before,  during,  and  immediately  after  the  menstrual  period, 
take  a  cold  dip  on  rising  in  the  morning.  It  must  be 
literally  a  quick  dip  in  a  tubful  of  cold  water,  from  65° 
to  55  °  F.,  or,  if  she  is  sufficiently  strong  to  stay  in  the  tub 
longer,  there  must  be  a  constant  brisk  friction  kept  up 
while  in  the  water. 

It  is  permitted  only  a  woman  in  good  health,  with  a 
strong  heart  and  normal  kidneys,  to  get  into  a  tub  of 
cold  water,  take  a  cold  plunge,  or  attempt  sea-bathing. 

For  the  woman  who  is  a  semi-invalid,  the  only  time 
allowable  for  a  cold  tonic  bath  is  in  the  afternoon. 

In  cold  weather  the  shower,  like  all  other  forms  of  baths, 
must  be  taken  in  a  warm  room.  The  shower  bath  can  be 
taken  every  day  to  the  greatest  possible  advantage.  An 
ideal  way  is  to  rest  for  half  an  hour  on  coming  home  in  the 
afternoon;  to  sleep,  if  possible,  then  take  a  quick  scrub, 
and  follow  it  first  by  the  hot  shower  of  100°  to  104°  F., 
and  finish  with  the  cold  shower.  A  brisk  rubbing  should 
be  kept  up  until  the  skin  is  in  a  good  healthy  glow. 
This  bath  is  followed  by  a  feeling  of  great  exhilaration, 
and  it  gives  a  beautiful  glow  to  the  face  and  skin.  It 
removes  the  tired  feeling  of  the  day's  work,  and  leaves 
one  feeling  greatly  refreshed  for  the  evening.  A  daily 
ablution  or  a  daily  shower,  with  friction,  will  not  cause  an 
undue  removal  of  the  oil  of  the  skin.  All  cold  baths,  when 
given  in  suitable  cases,  tone  up  the  system  to  resist  dis- 


THE  CAEE  OF  THE  SKIN  AND  ITS  APPENDAGES   57 

ease,  and  are  the  best  preventives  against  ordinary  colds 
and  sore  throat. 

A  hot  tub-bath  is  best  taken  at  night  just  before  retir- 
ing. In  winter  it  must  never  be  taken  immediately  before 
going  out-of-doors,  because  the  pores  of  the  skin  are  more 
or  less  open  and  there  is  great  danger  of  chilling.  A  hot 
tub-bath,  remaining  in  the  bath  for  some  minutes,  should 
not  be  taken  more  than  twice  a  week,  as  it  is  too  debilitat- 
ing, and  a  prolonged  stay  in  the  hot  water  causes  an  actual 
loss  of  flesh. 

A  woman  may  take  a  warm  sponge  bath  in  a  warm  room 
at  any  time  of  the  month,  but  during  the  menstrual  period 
she  must,  under  no  consideration,  take  a  cold  tub-bath  or 
even  a  cold  sponge-bath,  since  this  would  be  apt  to  cause 
a  chill  of  the  surface  of  the  body  and  a  congestion,  if  not 
an  actual  inflammation,  of  the  pelvic  organs. 

No  bath  should  be  taken  within  two  hours  after  eating, 
as  the  bath  draws  the  blood  from  the  stomach  toward  the 
surface  of  the  body  and  so  interferes  with  digestion. 

The  Care  of  Wash-cloths. — After  using  each  time,  the 
wash-cloth  must  be  thoroughly  washed,  well  rinsed,  and 
hung  up  to  dry.  But  this  is  not  sufficient:  once  every 
week  all  wash-cloths  must  be  sent  to  the  laundry  to  be 
boiled,  thus  insuring  the  destroying  of  any  germs  that  may 
lurk  in  the  cloth.  If  a  woman  has  any  kind  of  skin  disease, 
it  is  quite  possible  for  her  to  reinfect  herself  after  the  dis- 
ease has  apparently  become  cured.  Further,  each  mem- 
ber of  the  family  should  have  her  own  individual  towels, 
soap,  and  wash-cloths.  Aside  from  all  sanitary  questions, 
in  a  matter  so  intimate  as  the  bath,  there  is  something 
repulsive  in  the  thought  of  having  your  toilet  articles 
used  by  any  one  else. 

A  pure  Castile  soap  is  one  of  the  best  that  can  be  used. 
All  cheap  scented  soaps  should  be  avoided,  as  they  are 
apt  to  contain  impure  materials  that  will  actually  injure 
the  skin.  If  the  skin  is  rough,  rubbing  it  with  a  good 
sand-soap,  and  rubbing  the  same  on  the  flesh-brush,  will 
remove  many  of  the  scales  and  leave  the  skin  much 


68  PERSONAL  HYGIENE   FOR  WOMEN 

smoother  and  softer.  Medicated  soaps  should  never  be 
used  except  by  the  direction  of  a  physician. 

Cleansing  the  Face. — The  face  should  be  well  washed 
twice  a  day  with  cool  or  cold  water,  but  the  temperature 
of  the  water  should  not  be  below  60°  F.  The  degree  of 
coolness  must  be  determined  by  the  feelings  and  judg- 
ment of  the  individual.  If  the  face  were  washed  with  very 
hot  or  very  cold  water,  and  then  exposed  to  the  cold  air, 
the  skin  would  become  rough  and  chapped.  The  water 
should  be  soft.  To  soften  hard  water,  put  1  pound  of 
bran  into  a  muslin  bag,  place  in  4  quarts  of  water,  and  boil 
for  fifteen  minutes.  Add  enough  of  this  bran  water  to  the 
bath  to  make  the  water  milky. 

A  soft,  woven  face  towel,  kept  for  the  face  and  neck 
only,  should  be  used  with  a  moderate  degree  of  friction. 
Great  care  must  be  used  to  wipe  the  skin  thoroughly  dry. 

It  is  a  question  whether  the  daily  use  of  soap  on  the 
face  is  advisable;  for  the  healthy  skin  it  is  not  essential 
and  may  prove  very  injurious.  Soap  should  never  be 
used  on  the  face  in  winter  just  before  going  out-of-doors, 
as  this  would  cause  a  roughening  of  the  skin.  When  the 
hot  tub-bath  is  taken,  the  face  should  be  well  washed  with 
soap  and  hot  water,  plenty  of  friction  being  applied  by 
means  of  the  face  towel,  after  which  the  face  is  thoroughly 
rinsed  with  pure  water.  This  will  open  the  pores  of  the 
skin,  and  should  be  followed  by  the  use  of  cold  water, 
which  has  a  stimulant  action  on  the  blood-vessels  and 
improves  the  circulation  in  the  skin.  It  also  improves  the 
tone  of  the  elastic  fibers  in  the  skin  and  tends  to  delay  the 
appearance  of  wrinkles. 

If  there  is  any  tendency  to  dryness  of  the  skin,  a  good 
cold  cream  should  be  well  rubbed  in  just  after  bathing  the 
face.  The  cream  must  be  a  good  quality  and  perfectly 
fresh,  as  a  rancid  cream  is  irritating  to  the  skin.  Only 
so  much  of  the  cream  should  be  applied  as  will  be  absorbed 
by  the  skin.  When  the  skin  is  very  thin,  and  there  has 
been  loss  of  subcutaneous  fat  due  to  ill  health  or  other 
cause,  the  systematic  application  of  cream  in  this  manner 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   59 

aids  in  the  nutrition  of  the  skin;  and,  when  apphed  to  the 
neck  with  good  massage,  is  a  great  protection  against  sore 
throat  due  to  exposure  to  drafts  and  cold. 

Protection  of  the  Face. — The  cold  winds  of  winter 
cause  a  dryness  of  the  uncovered  skin  of  the  face  and  lips, 
which  often  leads  to  a  painful  chapping,  and,  in  the  case 
of  the  lips,  small  fissures  may  be  produced.  In  addition  to 
the  use  of  cold  cream,  a  good  rice  powder  may  be  applied, 
which  serves  as  a  further  protection  to  the  skin. 

In  very  cold  weather  a  veil  should  be  worn  to  protect  the 
face  from  the  cold  and  winds.  In  summer  a  parasol  should 
always  be  carried,  to  protect  the  eyes  and  brain  as  weU  as 
the  face  from  the  hot  rays  of  the  sun. 

The  Use  of  So-called  Cosmetics  for  the  Face.— 
All  skin  speciaHsts,  and  these  are  in  the  very  best  position 
to  judge  of  the  great  amount  of  harm  that  is  done,  say 
emphatically  that  the  use  of  face  lotions  and  "paints" 
can  only  work  the  lasting  injury  of  the  complexion. 
They  may  assist  in  hiding  the  defects  of  nature,  but  they 
frequently  contribute  to  increase  these  defects.  Many 
of  them  merely  fill  up  the  pores  of  the  skin  and  give  it  a 
pasty  look.  Numerous  cases  of  eczema  and  other  dis- 
eases have  followed  the  use  of  paints.  Of  the  advertised 
cosmetics,  many  are  not  only  worthless,  but  actually  in- 
jurious. 

Certain  applications  to  the  skin  of  the  face  are  permis- 
sible and  beneficial.  ''Virgin  milk,"  which  is  a  milky- 
looking  mixture,  composed  of  the  tincture  of  benzoin  and 
rose-water,  renders  the  skin  soft,  and  is  said  to  prevent  the 
formation  of  freckles.  If  the  skin  is  dry,  glycerin  may 
be  added  to  this.  The  formula  for  this  mixture  is  as 
follows :  Take  of  the  tincture  of  benzoin  and  glycerin  each 
1  ounce,  mix  well,  and  then  add  2  ounces  of  rose-water. 
This  should  be  applied  by  the  fingers,  just  after  the  face 
is  washed.  Pure  glycerin  is  irritating,  and  should  never 
be  applied  to  the  face  without  dilution. 

The  various  good  preparations  of  rice  and  talcum  pow- 
der on  the  market  are  perfectly  harmless,  and,  if  there  is  a 


60  PERSONAL  HYGIENE   FOR  WOMEN 

tendency  to  greasiness  or  shininess  of  the  skin,  the  use  of 
these  is  essential  from  an  esthetic  point  of  view.  In 
case  of  greasiness  a  Uttle  calcined  magnesia  may  be  used. 
In  hot  weather  the  use  of  face  powder  is  very  refreshing, 
and  in  the  hot  climates  it  is  used  for  this  purpose  to  a  very 
striking  extent.  But  the  true  cosmetics,  and  the  only 
ones  that  can  procure  and  keep  a  beautiful  complexion,  are 
plenty  of  exercise  in  the  open  air,  attention  to  the  diet, 
to  the  daily  evacuation  of  the  bowels,  to  the  condition  of 
the  kidneys,  to  baths,  and  to  proper  dress. 

Facial  Blemishes. — Among  the  most  common  facial 
blemishes  are  freckles,  liver  spots,  a  sallow  complexion, 
pimples,  acne,  eczema,  superfluous  hairs,  and  wrinkles. 

Freckles. — ^These  are  brownish  or  yellowish  pigmentary 
spots,  varying  from  the  size  of  a  pin-head  to  that  of  a  pea. 
They  occur  on  the  face  and  the  backs  of  the  hands. 
They  consist  of  a  circumscribed  deposit  of  pigment; 
not  much  is  known  about  their  origin.  The  pigment  is 
situated  in  the  deep  layers  of  the  epidermis,  and,  in  order 
to  remove  the  freckles,  it  is  necessary  to  use  something 
capable  of  producing  desquamation.  As  a  rule,  if  left 
alone,  they  will  gradually  disappear. 

lAver  Spots. — The  so-called  liver  spots  are  irregular 
patches  of  a  brownish  color,  which  appear  most  frequently 
on  the  face,  neck,  chest,  back,  arms,  and  hands.  If  not 
caused  by  disorders  of  the  liver  and  digestion,  they  are  cer- 
tainly aggravated  by  them.  They  are  not  only  unsightly 
blemishes  on  the  skin,  but  sometimes  cause  great  nervous- 
ness by  the  intense  itching  which  accompanies  them. 

Sallow  Complexion. — This  is  generally  caused  by  dis- 
orders of  the  liver,  and  is  most  frequently  met  with  in  hot 
countries.  It  is  seen  in  chronic  dyspeptics,  and,  indeed, 
in  most  forms  of  chronic  disease,  and  is  not  only  a  symp- 
tom of  the  disordered  bodily  state,  but  a  cause  of  its  per- 
petuation. This  appearance  of  the  skin  is  due  to  the 
accumulation  of  effete  matters  in  it  and  to  its  impaired 
nutrition,  and  this  state  exists  not  only  in  the  skin,  but  in 
the  whole  body. 


THE  CAEE  OF  THE  SKIN  AND  ITS  APPENDAGES   61 

Pimples,  or  Blackheads,  and  Acne. — These  are  affections 
of  youth,  and  are  generally  seen  together,  the  last-named 
being  simply  a  second  stage  of  the  first.  Pimples,  or 
blackheads,  appear  as  small  elevations  in  the  skin,  with  a 
small  black  point  in  the  center.  The  cause  of  the  pimple 
is  the  alteration  in  the  quality  of  the  sebum,  the  oily 
secretion,  which  becomes  and  remains  a  hard  mass  in  the 
excretory  ducts  of  the  sebaceous  glands  and  plugs  up  its 
external  opening.  The  dust  of  the  air  becomes  mixed 
with  the  fat,  and  thus  makes  a  black  point.  When  the 
ducts  cannot  get  rid  of  the  sebum,  they  become  stopped  up, 
and  in  consequence  become  swollen.  This  irritation 
spreads  to  the  adjacent  tissues,  and  so  inflammation  arises. 
Finally,  the  contents  of  the  duct  undergo  degeneration, 
suppuration  occurs,  and  the  contents  become  mixed  with 
pus,  small  abscesses  result  at  various  depths  in  the  skin, 
and  so  require  more  or  less  time  to  break  out. 

This  inflammatory  condition  of  the  sebaceous  glands 
with  their  ducts  is  apt  to  become  chronic  and  may 
prove  an  obstinate  affection.  It  occurs  most  commonly 
about  the  face,  on  the  back  between  the  shoulders,  or  on 
the  chest.  The  skin  is  rough  to  the  touch,  the  ducts  of  the 
sebaceous  glands  are  enlarged,  and  the  skin  is  greasy. 

Eczema. — This  is  the  most  common  of  all  skin  affec- 
tions. It  is  a  non-contagious,  inflammatory  disease  of  the 
skin,  sometimes  acute,  but  more  often  chronic,  attended 
with  itching  and  desquamation  or  loss  of  cuticle.  With  the 
itching  may  be  a  feeling  of  heat  and  tension  in  the  part. 

Eczema  is  a  local  disease,  brought  about  by  a  local 
irritation  in  the  skin;  but,  in  addition  to  this,  there  is 
generally  a  predisposing  cause,  as  some  disorders  of  the 
digestive  tract,  a  bad  condition  of  the  blood,  and  so  forth. 
The  skin,  like  other  organs  of  the  body,  depends  on  the 
whole  system  for  its  nutrition.  When  this  nutrition  is  not 
sufficient,  the  skin  appears  pale,  of  a  peculiar  color,  and  is 
easily  taken  up  in  folds,  an  evidence  of  poor  nutrition  of 
the  skin.  When  the  skin  is  not  properly  nourished, 
every  slight  irritation  is  liable  to  produce  eczema. 


62  PERSONAL  HYGIENE   FOR  WOMEN 

Treatment  of  Liver  Spots,  Sallow  Complexion, 
Pimples,  Acne,  and  Eczema. — First,  the  general  treat- 
ment. While  every  case  of  skin  disease  must  be  treated 
according  to  the  peculiarities  of  that  patient's  case,  still, 
there  are  general  rules  which  should  be  followed  in  the 
treatment  of  all  cases,  and  first  in  importance  comes  at- 
tention to  the  bowels.  There  must  be  procured,  by  some 
means  or  other,  a  free  daily  evacuation.  A  hard,  consti- 
pated movement  is  not  sufficient.  Fruits  and  vegetables 
are  both  laxatives  and  the  very  best.  Water  is  also  a 
laxative,  and  3  pints  a  day  should  be  taken,  not  only  for 
the  laxative  effects,  but  also  because  this  amount  is  needed 
to  keep  the  kidneys  properly  flushed.  Of  the  simple 
medicinal  laxatives,  one  of  the  best  is  the  effervescing 
granules  of  the  phosphate  of  soda;  the  dose  is  from  one 
teaspoonful  to  one  tablespoonful,  to  be  taken  in  a  glass 
of  cold  water  on  rising  in  the  morning.  Sometimes  pa- 
tients who  are  troubled  with  gas  cannot  take  anything 
which  effervesces;  in  that  case,  the  plain  phosphate  of 
soda  may  be  substituted. 

Next  in  importance  to  the  attention  to  the  bowels 
comes  the  diet.  All  articles  of  diet  must  be  easily  di- 
gested, while  at  the  same  time  they  are  nourishing. 
Cereals,  pies,  pastry,  fried  foods,  hot  breads,  rich  gravies, 
rich  salads,  pork,  and  veal  must  be  excluded  from  the 
bill  of  fare. 

Fresh  meat  must  be  eaten  by  a  woman  in  health  at  least 
once  a  day,  and  young  girls  need  it  twice  a  day.  This 
should  be  supplemented  with  eggs  and  milk,  fresh  vege- 
tables, and  not  an  excess  of  stale  bread  or  toast.  The 
latter  is  constipating.  Tea  and  coffee  should  both  be 
avoided. 

A  glass  of  hot  water,  taken  one  hour  before  meals, 
will  do  much  to  rid  the  stomach  of  mucus  and  put  it  in  a 
good  condition  for  the  digestion  of  the  food. 

For  the  congestion  of  the  liver,  which  is  so  often  at  the 
bottom  of  these  disorders,  it  is  generally  necessary  to 
consult  a  physician. 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   63 

Pure  air,  associated  with  the  proper  kinds  of  exercise, 

promotes  the  functions  of  the  skin,  assists  in  keeping  the 
blood  in  good  condition,  increases  the  vigor,  keeps  the 
complexion  clear,  and  increases  its  beauty,  while,  on  the 
other  hand,  a  sedentary  life  in  a  confined  air  produces  a 
pallid  and  frequently  a  blotched  skin,  with  headache  and 
dyspepsia. 

A  thin  condition  of  the  blood,  which  is  known  as  anemia, 
is  another  source  of  skin  diseases.  After  the  digestive 
system  has  been  gotten  in  a  good  condition,  some  form  of 
iron  is  generally  necessary,  which,  if  taken  when  the  diges- 
tive tract  were  not  in  good  condition,  would  do  more  harm 
than  good,  as  it  would  only  tend  to  still  further  clog  up  the 
system. 

Sweating  baths  are  of  the  highest  value  as  a  means  of 
ridding  the  skin  of  its  accumulated  impurities,  and  in 
unloading  the  obstructed  sebaceous  follicles  of  their 
hardened  contents. 

In  eczema  tub-baths  must  be  avoided,  and  soap  and 
water  be  used  sparingly.  Bran  may  be  added  to  the  water, 
or  baking  soda,  in  the  proportion  of  one  teaspoonful  to 
the  basin  of  water.  The  water  should  always  be  soft. 
The  use  of  water  on  the  face  should  be  at  once  followed  by 
the  use  of  cold  cream. 

Local  Treatment. — Without  the  correction  of  the  im- 
paired functions  of  the  general  system,  no  local  treatment 
can  afford  anjrthing  more  than  mere  temporary  relief; 
but,  as  a  rule,  local  treatment  is  necessary  in  addition  to 
the  general  treatment. 

Steaming  the  Face. — It  seems  that  the  blood-vessels  of 
the  skin  are  much  better  able  to  absorb  vapor  than  water. 
The  vapor  penetrates  and  softens  the  epidermis  much 
better  than  the  simple  application  of  water  would.  The 
increased  secretion  from  the  skin  which  is  thus  caused 
is  beneficial.  After  using  the  vapor  bath,  the  outer  layers 
of  the  epidermis  peel  off  and  the  complexion  is  improved 
by  the  substitution  of  new  pigment.  The  absorption  of 
the  moisture  also  causes  a  roundness  of  the  skin  and  a 


64  PERSONAL  HYGIENE   FOR  WOMEN 

filling  out  of  the  wrinkles.  Generally,  vapor  batha  can 
be  used  in  those  cases  of  skin  diseases  where  the  skin  is 
rough  and  dry.  Next  in  importance  to  the  vapor  bath 
is  steaming  the  face.  Bathing  the  face  with  very  hot 
water  is  also  recommended. 

Massage  of  the  Skin. — Where  the  complexion  is  sallow, 
or  there  is  a  tendency  to  pimples  or  blotches,  massage  of 
the  skin  of  the  face  will  do  much  to  improve  the  circulation. 

The  massage  is  most  effective  when  it  follows  steaming 
or  washing  the  face  in  hot  water.  The  tips  of  the  fingers 
should  be  dipped  in  cold  cream,  and  then,  pressure  being 
exerted  by  them,  the  skin  of  the  forehead  should  be 
deeply  stroked  from  the  middle  line  out  over  the  temples. 
The  nose  should  be  stroked  from  the  bridge  outward  and 
downward.  The  skin  of  the  cheeks  should  be  pinched  up 
and  rolled  between  the  fingers  and  thumb.  All  these 
movements  facilitate  the  emptying  of  the  follicles. 

In  case  of  black  points,  the  too  frequent  squeezing 
out  of  the  contents  must  be  guarded  against;  also  the  too 
strong  pressure  of  the  fingers.  These  are  often  so  deeply 
implanted  in  the  skin  that  very  strong  pressure  is  neces- 
sary, but  when  the  pressure  is  too  strong,  inflammation 
and  suppuration  may  result.  The  extremity  should  first 
be  opened  by  a  very  fine-pointed  lance,  which  must  be 
sterilized  before  using,  and  then  a  hollow  key  is  placed  over 
the  pimple  and  gently  pressed  down  over  it.  Through 
regular  and  even  pressure  over  the  sides  the  little  worm- 
like mass  is  quickly  pressed  out. 

If  these  procedures  are  not  sufficient,  more  heroic 
measures  must  be  resorted  to.  Some  of  the  skin  specialists, 
believing  that  acne  is  of  parasitic  origin,  use  antiseptic 
remedies,  and,  instead  of  ordinary  toilet  soap,  recommend 
the  use  of  the  officinal  green  soap  or  the  tincture  of  green 
soap.  After  the  use  of  this,  the  parts  are  to  be  thoroughly 
rinsed  and  sponged  for  five  or  ten  minutes  with  water  as 
hot  as  can  be  borne  and  wiped  dry.  When  the  skin  is 
oily  or  sluggish,  after  washing,  the  face  should  be  mas- 
saged by  going  over  the  parts  with  a  small  cupping  glass. 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   65 

witli  an  opening  of  about  1  inch.  This  not  only  massages 
the  face,  but  tends  to  empty  the  ducts.  The  face  is 
again  washed  with  soap  and  hot  water,  rinsed  off  with 
hot  water,  and  is  then  dashed  for  a  moment  or  two  with 
cold  water  and  wiped  dry.  After  this  the  remedial 
application  is  made.  These  procedures  are  best  carried 
out  at  night.  In  the  morning  tepid  water  is  used  to  wash 
the  face. 

The  following  preparations  will  be  found  to  be  effective 
in  many  cases.  Take  of  the  sulphate  of  zinc  and  the 
sulphuret  of  potassium,  each,  1  dram;  glycerin,  10  drops, 
and  water,  4  ounces.  If  any  irritation  or  scaliness  results, 
the  remedy  should  be  intermitted  for  one  or  two  nights 
and  a  good  cold  cream  used  instead. 

For  freckles  and  liver  spots  the  following  prescriptions 
wiU  be  found  useful:  Take  of  powdered  borax,  1  dram; 
of  the  hyposulphite  of  soda,  2  drams,  and  dissolve  in  4 
ounces  of  water.  This  should  be  applied  after  washing 
the  face  with  hot  water.  The  wash  may  be  applied  with 
the  fingers  or  with  absorbent  cotton;  it  is  to  be  immediately 
followed  by  this  powder.  Take  of  the  oleate  of  zinc,  2 
drams,  and  of  the  oxid  of  zinc,  1  ounce.  This  must  be 
well  mixed  and  powdered  finely.  It  should  be  applied 
with  absorbent  cotton,  while  the  skin  is  still  moist  from 
the  use  of  the  wash.  This  covers  the  face  with  a  mask, 
and  should  be  used  at  night  only.  As  both  of  these  appli- 
cations are  astringent,  their  use  must  not  be  kept  up  for 
too  long  a  time,  or  the  skin  will  become  dry  and  rough. 
They  are  very  effective  where  the  skin  is  greasy. 

For  an  obstinate  case  of  freckles  or  liver  spots  the  fol- 
lowing is  recommended:  Take  of  the  corrosive  chlorid 
of  mercury,  6  grains;  of  the  oil  of  lavender,  10  drops;  of 
alcohol,  1  ounce;  and  of  glycerin,  2  ounces.  Mix  well, 
and  apply  at  night. 

For  hyperidrosis,  or  profuse  sweating  in  the  axilla,  of  the 
feet  or  hands,  take  of  salicylic  acid,  15  grains;  of  starch, 
i   dram;   and   of  talcum  powder,    1   ounce.     Mix  well, 
and  dust  over  the  parts  night  and  morning. 
5 


66  PERSONAL  HYGIENE   FOR  WOMEN 

Eczema  is  such  an  obstinate  affection  that  the  patient 
should  at  once  seek  the  advice  of  a  good  physician;  for 
the  longer  the  disease  lasts,  the  more  difficult  its  cure 
becomes. 

Removal  of  Superfluoiis  Hairs. — One  of  the  best  depila- 
tories consists  of  the  sulphid  of  barium,  2  drams;  the  oxid 
of  zinc  and  starch,  each,  3  drams.  Mix  these  well,  and 
keep  tightly  corked.  At  the  time  of  the  application  suffi- 
cient water  is  added  to  make  a  paste,  which  is  thickly 
spread  over  the  part  and  allowed  to  remain  on  for  a  min- 
ute or  two.  It  is  then  washed  off  and  a  Httle  soothing 
ointment  applied.  A  variable  amount  of  redness  follows; 
the  object  is  to  allow  the  paste  to  remain  on  long  enough 
to  destroy  the  hair,  and,  at  the  same,  to  limit  the  resulting 
irritation.  Ordinarily,  a  shght  burning  or  sensation  of 
warmth  is  an  indication  that  the  paste  has  been  on  long 
enough.  The  application  is  repeated  as  soon  as  the  hair 
reappears — about  every  one  or  two  weeks. 

Peroxid  of  hydrogen  may  be  used  instead  for  its  bleach- 
ing properties,  especially  in  patients  with  a  dark  growth. 
It  should  at  first  be  diluted  with  equal  parts  of  water 
and  the  strength  gradually  increased.  A  piece  of  cotton 
is  wet  with  the  solution,  and  applied  to  the  region  to  be 
treated  and  left  in  place  for  several  minutes.  The  pro- 
cedure is  repeated  daily  until  the  desired  result  is  obtained. 
The  hair  gets  lighter  and  lighter  in  color  and  finally  disap- 
pears. Of  course,  the  hair  follicles  are  not  destroyed,  so 
that  the  hair  will  grow  again,  necessitating  another  course 
of  treatment. 

For  the  removal  of  large  stiff  hairs,  electrolj^sis  is  the 
only  safe  and  sure  method,  and  no  one  but  an  experienced 
operator  should  be  allowed  to  do  this. 

Never  use  an  ointment  on  the  face  that  contains  vaselin 
or  lanolin,  but  particularly  the  former,  as  they  are  both 
apt  to  produce  a  growth  of  hair,  but  these  preparations 
are  excellent  to  increase  the  growth  of  the  eyebrows. 

Wrinkles. — In  very  many  cases  wrinkles  are  the  result 
of  habit  of  expression,  as  in  scowling;  or  an  expression  of 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   67 

dejection,  when  the  angles  of  the  mouth  curve  downward, 
and  so  forth. 

There  are  twenty-eight  muscles  about  the  mouth. 
Since  all  these  muscles  are  developed  by  use,  the  mouth 
comes  to  assume  the  expression  given  to  it  by  the  thoughts 
of  the  individual.  The  figurative  expression,  "  down  at 
the  mouth,"  comes  to  be  literally  true,  and  the  angles  of 
the  mouth  are  seen  to  be  habitually  drooping,  until  at 
last  this  is  the  fixed  expression  of  the  face.  A  healthy 
frame  of  mind  is  the  only  means  to  keep  the  face  from 


Fig.  3. — Muscles  of  the  right  side  of  the  head  and  neck. 


being  converted  into  a  map  of  wrinkles  and  drooping 
angles  at  the  mouth. 

The  wrinkles  are  not,  as  a  rule,  caused  by  any  trouble 
in  the  skin  itself,  but  in  the  underlying  muscles,  the 
tissues  of  which  have  become  relaxed  or  weakened.  The 
circulation  of  the  parts  may  be  stimulated,  and  so  in- 
creased nourishment  be  secured  by  deep  massage  of  the 
muscles,  and,  at  the  same  time,  the  use  of  a  good  cold 
cream  will  aid  in  the  nourishment  of  the  skin. 

The  face  should  first  be  washed  and  steamed  according 
to  the  directions  already  given.     The  massage  of  the  face 

I 


68  PERSONAL  HYGIENE   FOR  WOMEN 

should  always  be  carried  out  in  a  systematic  manner. 
Begin  with  the  forehead.  Stroke  with  the  two  thumbs 
over  the  forehead,  starting  near  the  eyebrows,  and  work 
out  toward  the  roots  of  the  hair.  In  the  second  move- 
ment one  hand  is  used  to  stretch  the  part  worked  upon, 
while  deep  friction  is  made  with  the  tips  of  the  fingers  of 
the  other  hand. 

For  wrinkles  about  the  eyes,  stroke  with  the  tips  of  the 
fingers,  over  and  below  the  eyes,  from  the  nose  toward  the 
temples.  Great  care  must  be  taken  not  to  apply  too  much 
cold  cream  about  the  eyes,  lest  some  of  it  should  get  into 
them.  For  the  removal  of  the  " crow's  feet"  at  the  outer 
angle  of  the  eye  stretch  the  part  with  the  thumb  and  finger 
of  one  hand,  and  perform  friction  with  the  tips  of  the  fingers 
of  the  other  hand. 

To  remove  the  lines  that  run  from  the  corners  of  the  nose 
to  the  angles  of  the  mouth,  stroke  with  both  hands,  one  on 
each  side  of  the  face,  beginning  at  the  center  and  lower 
part,  and  stroke  upward  toward  the  temples.  This  up- 
ward motion  counteracts  the  drawn  and  pulled-down 
condition  of  the  face. 

For  the  cheeks,  use  both  friction  and  deep  kneading; 
pick  up  the  muscles  between  the  thumb  and  finger. 

To  remove  wrinkles  under  the  chin  and  a  double  chin, 
begin  at  the  middle  line,  and  with  both  hands  make  deep 
pressure  upward  and  outward.  To  remove  superfluous 
fat,  make  deep  friction  with  the  tips  of  the  fingers.  In 
the  latter  case,  only  use  enough  cocoa-butter  on  the 
fingers  to  prevent  the  friction  against  the  skin.  The 
benzoin  preparations,  already  given,  will  help  to  contract 
the  tissues. 

A  cold  cream  which  is  a  good  skin  food  is  the  follow- 
ing: Take  of  the  oil  of  sweet  almonds,  2  ounces;  of  sper- 
maceti, I  ounce ;  of  white  wax,  J  ounce ;  and  of  rose-water, 
^  ounce.  Melt  together  at  a  moderate  heat,  the  oil, 
spermaceti,  and  wax,  then  gradually  add  the  rose-water; 
stir  the  mixture  briskly  and  constantly  until  it  is  cool, 
and  continue  the  stirring  until  it  has  become  uniformly 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES  69 

soft  and  creamy.  The  Dover  egg-beater  will  give  it  the 
desired  creamy  appearance. 

The  Hair. — From  an  esthetic  point  of  view,  a  head  of 
luxuriant  hair  is  a  matter  of  prime  importance  to  the 
woman. 

The  hairs  are  peculiar  modifications  of  the  epidermis. 
The  hair  follicle  is  a  cylindric-shaped  depression  of  the 
skin,  whose  fimnel-shaped  mouth  opens  on  the  free  sur- 
face. Immediately  below  this  is  a  constriction^  called  the 
neck,  which  is  the  narrowest  part  of  the  follicle;  the  duct 
of  the  sebaceous  gland,  which  suppUes  the  hair  with  oil, 
opens  at  this  point.  The  base  of  the  follicle  is  bulb-shaped, 
to  accommodate  the  hair-papilla  and  the  hair-bulb.  The 
hair-papilla  contains  the  blood  and  nerve  supply  for  the 
hair.  When  a  hair  is  plucked  or  falls  out,  a  new  hair  grows 
from  the  hair-papilla. 

According  to  Pincus,  the  life  of  a  hair  ranges  from  two 
to  six  years,  after  which  it  falls  out,  to  be  replaced  by  a 
new  one.  In  this  way  about  fifty  or  sixty  hairs  are  nor- 
mally shed  every  day. 

In  order  to  have  thick,  luxuriant,  silky  hair  great  atten- 
tion must  be  paid  to  the  condition  of  the  scalp,  since  it  is 
the  scalp  which  contains  the  blood-vessels  that  nourish 
the  hair.  The  scalp  should  be  thick  and  pliable  and  move 
freely  over  the  bones  of  the  skull.  If  the  scalp  is  drawn 
tightly  over  the  bones  of  the  skull,  it  tends  to  constrict 
the  blood-vessels,  and  so  lessen  the  supply  of  blood  to  the 
scalp  and  cause  atrophy  of  the  roots  of  the  hair  from  pres- 
sure. 

The  hair  has  a  great  tendency  to  accumulate  dirt.  It 
catches  the  dust  flying  in  the  air,  and  also  retains  the  secre- 
tion of  fat  and  the  desquamated  epithelium  of  the  scalp 
and  the  products  of  perspiration. 

The  two  chief  causes  of  the  premature  thinness  of  the 
hair  are  a  deficient  circulation  of  blood  in  the  scalp  and 
dandruff,  and  it  is  said  that  dandruff  causes  the  loss  of 
hair  in  70  per  cent,  of  all  cases. 

Dandruff. — The  last  few  years  has  witnessed  a  revolu- 


70  PERSONAL  HYGIENE   FOR  WOMEN 

tion  in  the  views  of  the  skin  speciaHsts  in  regard  to  the 
cause  of  dandruff.  Previous  to  that  time  it  was  consid- 
ered as  simply  a  collection  of  epithelial  scales  mixed  with 
more  or  less  oily  matter.  Now,  following  the  investiga- 
tions that  were  first  instituted  by  Unna,  dandruff  is  con- 
sidered as  a  symptom  of  a  parasitic  disease  of  the  scalp, 
called  seborrheic  eczema.  Sabouraud  believes  that  the 
same  parasite  that  produces  seborrhea  causes  the  loss  of 
hair.  It  is  believed  that  the  parasite  grows  down  into  the 
hair  follicle,  between  its  walls  and  the  hair. 

Seborrheic  eczema  is  a  chronic  desquamative  inflam- 
mation of  the  scalp  of  bacterial  origin.  It  is  divided  into 
two  stages:  the  first  may  last  from  one  to  seven  years;  it 
is  attended  with  more  or  less  dandruff  in  the  form  of  scales 
and  dryness  of  the  hair;  or  the  dandruff  may  unite  with 
the  oil,  producing  fatty  crusts  which  are  removed  with 
difficulty.  This  is  followed  by  the  second  stage,  in  which 
the  hair  falls  out. 

Symptoms  of  Seborrheic  Eczema. — In  the  dry  form  of  the 
disease,  in  which  there  is  a  scaling  of  the  scalp,  the  hair  is 
dry  and  unmanageable,  the  head  itches,  especially  when 
the  patient  sits  under  a  light  or  becomes  overheated. 
There  is  a  more  or  less  constant  falling  of  the  scales  upon 
the  clothes.  The  scalp  looks  pale,  and  will  be  found 
covered  with  fine  grayish  or  yellowish,  readily  detachable 
scales.  Sometimes  there  is  more  or  less  redness  of  the 
scalp.     This  is  the  mildest  grade  of  the  disease. 

That  dandruff  is  contagious  has  been  proved  by  experi- 
ment, experience,  and  treatment.  Lassar  and  Bishop 
made  a  pomade  of  the  scales  taken  from  the  head  of  a 
student  who  was  suffering  from  this  disease,  and  rubbed  it 
into  the  backs  of  guinea-pigs,  which  caused  the  same  dis- 
ease in  them,  and  falling  out  of  the  hair. 

Cases  have  been  reported  in  which  husband  and  wife 
have  contracted  dandruff  after  marriage,  he  or  she  having 
been  free  before. 

The  drugs  that  are  most  efficacious  in  the  cure  of 
seborrhea  are  active  antiparasitics. 


THE   CARE   OF  THE  SKIN   AND   ITS  APPENDAGES      71 

Causes  of  Seborrheic  Eczema. — The  general  causes  are 
debility,  constipation,  and  anything  which  undermines  the 
general  health.  The  local  causes  are  lack  of  cleanliness  of 
the  scalp,  and  using  combs  or  hair-brushes  which  have 
been  used  on  the  scalps  of  persons  who  were  suffering 
from  this  disease. 

In  most  families  will  be  found  one  or  more  mem- 
bers who  possess  enough  seborrheic  infection  to  cause 
the  spread  of  the  disease  throughout  the  rest  of  the 
household. 

Causes  and  Treatment  of  Premature  Thinness  of 
the  Hair  and  Baldness. — It  has  already  been  stated  that 
70  per  cent,  of  these  cases  were  caused  by  seborrheic 
eczema.  Among  other  causes  may  be  mentioned  a  pro- 
gressive tightening  of  the  scalp  upon  the  skull,  the  scalp 
having  lost  the  cushion  of  fat  that  is  under  it  in  early  life ; 
insufficient  or  improper  care  of  the  scalp ;  daily  sousing  of 
the  head  in  cold  water,  combined  with  improper  drying 
of  the  hair  afterward;  sweating  of  the  head;  constant 
mental  strain,  either  on  account  of  intellectual  work  or 
worry;  wearing  stiff,  unyielding  hats;  gout,  and  aU  diseases 
which  lower  the  general  nutrition. 

The  chief  treatment  is  by  prophylaxis,  or  using  pre- 
ventive measures  to  insure  the  healthy  condition  of  the 
scalp.  And  first  and  most  important  of  these  is  cleanli- 
ness. Because  of  the  great  length  of  time  which  it  takes 
to  dry  long,  thick  hair,  many  women  do  not  wash  the  scalp 
often  enough.  In  the  healthy  state  of  the  scalp  it  should 
be  washed  at  least  once  a  month. 

The  Care  of  the  Hair. — There  is  never  any  danger  of 
shampooing  the  healthy  scalp  too  frequently.  The  oil  in 
the  scalp  is  not  removed  by  washing,  but  is,  on  the  con- 
trary, always  increased  through  the  improvement  in  the 
circulation.  Where  there  is  much  dandruff,  or  if  the  hair 
has  begun  to  fall  out  prematurely,  owing  to  long  neglect 
or  following  an  illness,  it  is  well  to  begin  by  washing  the 
hair  two  or  three  times  a  week,  and  then  gradually  in- 
crease the  interval  to  every  two  or  three  weeks. 


72  PERSONAL  HYGIENE  FOR  WOMEN 

Borax  in  the  water  cleanses  the  scalp  well,  but  its  con- 
tinuous use  is  injurious;  the  same  may  be  said  of  am- 
monia water. 

One  of  the  best  shampoos  is  the  tincture  of  green  soap. 
If  this  cannot  be  obtained,  take  of  the  official  green  soap 
2  ounces,  and  of  alcohol,  1  ounce;  mix  well,  and  make 
shampoo.  One  ounce  of  the  tincture  or  its  substitute 
should  be  diluted  with  twice  as  much  water  and  applied 
to  the  scalp  with  the  tips  of  the  fingers.  When  enough  of 
the  shampoo  has  been  used,  add  sufficient  water  to  make 
a  good  lather.  This  must  be  thoroughly  rubbed  into  the 
scalp,  going  over  the  whole  systematically.  After  the 
scalp  is  cleansed,  the  soap  must  be  well  rinsed  out  of 
the  hair.  This  may  require  many  changes  of  the  water, 
but  it  is  most  important.  Dry  the  hair  with  hot  towels, 
the  process  being  completed  by  a  radiator  or  stove  oven. 
Fanning  the  hair  will  hasten  the  process  very  consider- 
ably. The  hair  should  then  be  loosely  braided  and  a  hot 
towel  wound  around  the  head  to  insure  perfect  dryness 
of  the  hair  and  as  a  prevention  against  taking  cold. 
One  hour  is  sufficient  for  the  entire  procedure.  In  winter 
the  hair  should  be  washed  just  before  retiring. 

Brushing  the  Hair. — Brushing  increases  the  growth  of 
the  hair  by  stimulating  the  circulation  in  the  scalp  and  by 
removing  the  dandruff.  To  be  effective,  the  hair  should 
be  well  brushed  at  least  once  a  day,  when  there  must  be  a 
deep  brushing  of  the  entire  scalp.  The  bristles  of  the 
brush  must  be  stiff  enough  to  warm,  but  not  to  scratch, 
the  scalp.  Brushing  and  massage  remove  any  loose  hairs 
that  are  ready  to  fall,  but  they  wiU  soon  be  replaced  by 
new  vigorous  ones. 

Combing  simply  disentangles  the  hair.  The  teeth  of 
the  comb  must  be  far  apart  and  have  rounded  ends.  In 
no  case  should  a  fine-toothed  comb  be  used.  It  tears  out 
the  hair,  and  often  causes  an  irritation  of  the  scalp  which 
leads  to  disease. 

From  what  has  been  said,  it  will  be  seen  that  every 
member  of  the  family  should  have  a  brush  and  comb  for 


THE  CARE   OF  THE   SKIN  AND   ITS   APPENDAGES      73 

her  own  exclusive  use,  and  that  no  one  should  allow  a 
public  brush  or  comb  to  be  used  on  her  head. 

The  brush  and  comb  must  be  washed  once  a  week  in 
water  containing  a  little  ammonia;  they  must  be  well 
rinsed  out  in  pure  water;  the  brush  should  be  dried 
quickly,  with  the  bristles  down.  If  the  brush  and  comb 
are  not  cleaned  sufficiently  often,  the  scales  of  dandruff 
would  be  sufficient  to  reinfect  the  scalp. 

Massage  of  the  Scalp. — The  scalp  should  be  thoroughly 
massaged  every  night.  Grasp  the  scalp  with  both  hands 
laterally,  as  well  as  anteroposteriorly,  and  with  some  press- 
ure loosen  the  tissues  from  the  underlying  parts  and  try 
to  raise  it  in  folds,  or  it  may  be  pinched  with  the  forefingers, 
producing  some  vascular  flux  and  a  sense  of  warmth. 

Stelwagon  recommends  the  use  of  electricity  two  or 
three  times  a  week,  by  means  of  a  metallic  brush  attached 
to  a  faradic  battery. 

If  the  scalp  is  too  dry,  nothing  is  better  than  pure 
vaselin,  though  some  persons  prefer  olive  oil,  applied  by 
means  of  a  dropper.  The  yolks  of  eggs  beaten  up  with 
lime-water  make  an  elegant  shampoo. 

For  the  cure  of  dandruff,  the  following  prescription  will 
be  found  to  be  of  great  service.  Take  of  resorcin,  2  drams; 
of  grain  alcohol,  3  drams;  of  glycerin,  f  ounce;  and  of 
rose-water,  a  sufficient  quantity  to  make  4  ounces.  This 
should  be  applied  to  the  scalp  with  the  fingers  every  night 
before  the  massage  of  the  scalp.  Since  resorcin  sometimes 
undergoes  a  change  of  color  that  gives  to  light,  gray,  or 
white  hair  a  dingy,  or  dirty  yellowish  color,  this  may  be 
obviated  by  the  addition  of  10  grains  of  salicylic  acid  to 
the  oimce  of  the  solution. 

For  an  oily  condition  of  the  scalp  with  thinness  of  the 
hair  the  following  is  an  excellent  formula:  Take  of  the 
carbonate  of  ammonia,  20  grains;  of  the  tincture  of  can- 
tharides,  1  dram;  of  alcohol,  |  ounce;  and  of  bay-rum,  a 
sufficient  quantity  to  make  4  ounces.  This  should  be  well 
mixed,  and  applied  at  night  with  a  good  massage  to  the 
scalp. 


74  PERSONAL  HYGIENE  FOR  WOMEN 

For  dryness  with  thinness  of  the  hair,  take  of  the  tinc- 
ture of  cantharides  and  of  the  tincture  of  capsicum, 
each,  li  drams;  of  castor  oil,  2  drams;  and  of  cologne 
water,  1  ounce.  Mix  well  and  apply  at  night.  Or  a 
prescription  containing  more  oil  is  the  following:  Take 
of  the  tincture  of  cantharides  and  of  the  tincture  oi-  cap- 
sicum, each,  2  drams;  of  cologne  water,  1  ounce;  and  of 
olive  oil,  a  sufficient  quantity  to  make  4  ounces. 

Dressing  the  Hair. — Dragging  or  twisting  the  hair  from 
its  natural  direction,  pulling  it  into  constrained  or  arti- 
ficial positions,  and  even  twisting  the  hair  very  tightly 
is  injurious  to  it. 

The  curling  iron  acts  by  abstracting  more  moisture  on 
one  side  of  the  hair  than  on  the  other.  The  stronger  the 
hair,  the  more  easily  it  will  curl,  and  the  longer  it  will  stay 
curled.  The  daily  use  of  a  hot  iron,  notwithstanding 
the  greatest  care,  will  in  a  short  time  prove  injurious; 
the  hair  is  apt  to  become  thin  and  fall  out.  Its  growth 
is  interfered  with.  The  use  of  kid  curlers  is  much  less 
injurious,  but  even  here  the  tight  twisting  of  the  hair 
around  the  kids  is  said  to  be  harmful. 

Shell  hair-pins  are  the  best  for  the  hair.  If  steel  ones 
are  used,  the  points  must  be  smooth  and  the  pins  kept 
in  good  condition. 

When  the  hair  is  dressed  for  the  night,  after  the  scalp 
has  been  brushed  and  massaged,  it  should  be  loosely 
braided  and  left  hanging  down. 

Gutting  the  hair  1  inch,  every  two  or  three  months,  is 
said  to  promote  the  growth  of  the  hair  and  prevent  its 
splitting.     It  does  not  increase  the  number  of  hairs. 

There  is  no  truth  in  the  assertion  that  the  hair  is  a  hol- 
low tube,  which  allows  the  escape  of  oil,  and  that  if  the 
ends  are  sealed  by  singeing  much  good  will  result. 

Gray  Hair. — Grayness  of  the  hair  may  be  either 
premature  or  physiologic.  When  the  grayness  is  due  to 
some  temporary  cause,  as  anxiety  or  some  diseased  state, 
the  process  may  cease  completely  on  the  removal  of  the 
cause.     Usually  the  whitening  is  permanent.     The  gray- 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   75 

ness  of  the  hair  is  caused  by  obscure  changes  in  the 
nutrition  of  the  hair-papilla,  which  interfere  with  the 
production  of  the  pigment.  As  a  rule,  the  hair  whitens 
first  on  the  temples,  then  on  the  top  of  the  head. 

The  hair  first  turns  gray  at  its  root.  The  grayness  is 
due  to  the  loss  of  pigment.  Prolonged  residence  in  either 
a  very  cold  or  a  very  hot  climate  will  cause  the  hair  to 
turn  gray. 

A  yellowish  tinge  of  the  hair  is  sometimes  seen  in  pa- 
tients with  jaundice,  or  gray  hair  may  owe  its  dull  yellow 
color  to  the  tint  of  dry  albumin  of  which  it  is  composed. 
The  glitter  of  steel-gray  or  silver-white  hair  is  due  to  the 
high  refractive  power  of  the  minute  air-bubbles  that  lie 
in  the  substance  of  the  hair. 

Treatment. — The  color  caimot  be  restored  to  gray  hair. 
The  roots  of  the  hair  are  embedded  in  the  hair  follicles, 
and  cannot  be  reached  by  any  fluids  applied  to  the  scalp. 
Not  only  is  the  use  of  hair-dyes  to  be  deprecated  as  an 
exhibition  of  poor  taste,  which  happily  is  going  out  of 
fashion,  but  the  use  of  hair-dyes  is  extremely  dangerous. 
Cases  are  being  constantly  reported  by  physicians,  where 
the  use  of  these  supposedly  simple  vegetable  hair-dyes 
has  been  followed  by  very  serious  and  extensive  derma- 
titis of  the  face,  neck,  and  shoulders. 

Gray  hair  is  really  very  beautiful  when  it  is  of  silvery 
whiteness,  and  very  ugly  when  it  is  of  a  yellowish-white 
color.  It  must  be  treated  with  much  greater  care,  in 
order  to  preserve  its  silvery  whiteness,  than  was  neces- 
sary to  keep  the  hair  in  good  condition  before  it  lost  its 
coloring  pigment.  It  should  never  be  wet,  except  when 
it  is  shampooed.  For  this  reason,  instead  of  using  hair- 
curlers,  crimping  pins  should  be  used.  In  this  way  the 
hair  is  waved  quite  as  weU  and  the  use  of  water  is  avoided. 

The  Cosmetic  Care  and  Treatment  of  the  Hands. — 
Of  all  the  members  of  the  body,  next  to  the  face,  the 
hands  have  the  most  expression,  and  serve  as  an  index 
of  character  and  refinement. 

Not  only  should  the  most  scrupulous  attention  be  given 


76  PERSONAL  HYGIENE   FOR  WOMEN 

to  having  clean  hands  and  nails,  but  every  precaution 
should  be  taken  to  keep  the  skin  soft  and  the  nails  care- 
fully manicured.  This  is  quite  possible  for  the  housewife, 
simply  by  wearing  rubber  gloves  while  she  does  her  work. 
It  preserves  the  fine  sense  of  touch  in  the  fingers,  which  aids 
in  sewing  and  embroidery,  at  the  same  time  that  it  adds 
much  to  the  beauty  of  the  hands. 

Chapped  Hands. — ^To  prevent  chapping  of  the  hands 
in  cold  weather  heavy  gloves  must  be  worn  or  a  muff 
carried.  Another  aid  in  the  prevention  of  the  skin  of  the 
hands  from  becoming  rough  and  chapped,  and  the  best 
means  for  curing  them  if  this  has  occurred,  is  by  the 
use  of  a  good  cold  cream  at  night,  just  before  retiring. 
The  cold  cream  should  be  well  rubbed  in  the  skin,  espe- 
cially about  the  finger-nails,  and  after  this  talcum  powder 
be  dusted  over.  This  forms  a  thick  covering  for  the  hands, 
the  talcum  powder  prevents  the  cream  from  being  rubbed 
off  on  the  bed-clothes,  and,  on  getting  up  in  the  morning, 
the  skin  will  be  found  to  be  soft.  Only  in  case  the  hands 
are  very  badly  chapped  should  old  kid  gloves  be  worn  at 
night. 

Cosmetic  of  the  Nails. — The  physiologic  function  of  the 
nails  is  to  protect  the  tips  of  the  fingers  against  pressure 
and  to  give  them  a  firm  support ;  this  increases  the  delicacy 
of  the  tactile  sensations. 

The  nails  should  be  slightly  curved  from  side  to  side,  of 
a  light  rose  color,  and  smooth  surface.  The  lunula  should 
be  visible  at  the  root  of  the  nail.  Brittleness  of  the  nails 
is  a  defect,  which  causes  them  to  tear  easily;  it  is  generally 
due  to  the  condition  of  the  general  health. 

There  is  a  natural  tendency  for  the  dirt  to  accumulate 
on  the  under  surface  of  the  nail,  between  it  and  the  finger. 
This  is  not  only  unsightly,  but  it  is  often  the  cause  of 
actual  danger,  as  this  forms  a  lodgment  for  the  germs  of 
disease.  Not  only  is  it  necessary  for  doctors  and  nurses 
to  give  the  most  scrupulous  attention  to  the  care  of  the 
nails,  but,  when  we  learn  that  one  cook  has  been  the  cause 
of  spreading  typhoid  fever  through  a  number  of  families, 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   77 

in  her  itinerary  in  going  from  place  to  place,  we  must  be 
impressed  with  the  necessity  of  more  careful  oversight 
being  given  to  the  hands  of  domestics  and  housewives 
who  prepare  the  food. 

For  the  same  reason,  it  is  self-evident  that  the  hands 
should  always  be  washed  immediately  before  going  to  the 
table,  and  cleaning  the  nails  is  always  a  finishing  touch  in 
the  washing  of  the  hands. 

For  the  purpose  of  cleansing  the  nails,  an  orange  stick 
or  nail-file  should  be  used,  and  never  the  point  of  the  scis- 
sors or  the  blade  of  a  knife,  for  either  of  these  causes  a 
roughening  of  the  under  surface  of  the  nails,  whereby 
the  lodgment  of  dirt  becomes  only  the  more  securely 
fixed.  After  the  use  of  the  nail-file,  the  nail-brush  should 
be  used,  followed  again  by  the  use  of  the  file  or  stick. 
If  there  is  a  tendency  to  a  roughening  of  the  skin  under 
the  nail,  it  can  be  obviated  by  the  use  of  cold  cream  at 
night.  Just  before  retiring,  the  fingers  should  be  dipped 
into  cold  cream,  and  let  the  tips  take  up  just  as  much  as 
they  will  retain,  and  after  this  dipped  into  talcum  powder. 

The  small  rim  of  epidermis  which  laps  over  the  nail 
should  be  gently  shoved  back  with  the  orange  stick  every 
day.  This  skin,  when  torn,  forms  the  so-called  hang- 
nails, by  which  infection  easily  enters  the  system;  it 
may  give  rise  to  felons  or  even  to  general  blood-poison- 
ing. 

Warts. — These  are  unsightly  blemishes  on  the  hands. 
They  may  be  removed  by  the  systematic  use  of  the  follow- 
ing lotion:  Take  of  salicylic  acid,  1  dram;  flexible  collo- 
dion, 1  ounce.  Mix  well.  This  should  be  painted  on  the 
wart  with  a  camel's-hair  brush  twice  a  day  for  two  or  three 
days,  without  removing  the  pellicle.  At  the  end  of  that 
time  the  wart  should  be  soaked  in  water  and  scrubbed  with 
pumice  stone.  This  usually  brings  away  part  of  the  homy 
covering.  The  treatment  is  continued  until  the  wart  has 
entirely  disappeared. 

When  the  warts  are  small,  they  may  often  be  removed 
by  simply  keeping  them  dry  and  applying  boric  acid. 


78  PERSONAL  HYGIENE   FOR  WOMEN 

The  Care  of  the  Feet. — In  the  care  of  the  feet  it  must 
be  remembered  that  the  leather  of  the  closely  fitting  boot 
allows  very  little  ventilation,  and  so  more  attention  must 
be  paid  to  the  airing  of  the  feet  as  well  as  to  their  bathing. 
The  feet  should  be  bathed  twice  daily. 

On  making  the  toilet  for  the  evening  dinner  both  shoes 
and  stockings  should  be  changed,  the  stockings  hung  up  in 
the  room,  and  the  shoes  left  out  to  air  and  dry,  instead  of 
being  stuffed  into  the  shoe-bag,  to  remain  there  until 
the  next  morning. 

An  alcohol  rub  will  be  found  very  refreshing  to  weary 
feet.  For  profuse  perspiration  of  the  feet,  boric  acid  or 
talcum  powder  may  be  used,  dusting  the  powder  over  the 
feet  both  night  and  morning. 

Ingrowing  Toe-nails. — The  common  causes  of  ingrowing 
toe-nails  are  improper  foot-wear  and  an  improper  method 
of  cutting  the  nails.  If  the  nail  is  cut  too  short,  especially 
at  the  angles,  while  at  the  same  time  the  shoe  is  too  short 
or  too  narrow,  the  skin  of  the  toe  is  forced  over  the  nail, 
so  that  it  necessarily  happens  that,  by  the  further  growth 
of  the  nail,  the  flesh  of  the  toe  is  pushed  still  further  over, 
until  a  point  is  reached  where  inflammation  is  set  up. 
There  is  excruciating  pain,  which  may  be  accompanied  by 
the  formation  of  a  small  tumor,  which  forms  pus  and  may 
go  on  to  granulation — the  so-called  "proud  flesh." 

The  preventive  measures  of  the  trouble  are,  first,  in 
cutting  of  the  nails.  The  toe-nail  should  be  cut  in  a  con- 
cave form,  the  outer  angle  projecting  be^'^ond  the  toe. 
If  there  is  a  tendency  for  the  flesh  to  grow  over  the  nail, 
the  flesh  should  be  pushed  back  from  the  nail,  and  fast- 
ened in  this  position  with  a  strip  of  oxid  of  zinc  plaster, 
and  a  gauze  packing  should  be  inserted  under  the  nail- 
edge.  A  saturated  solution  of  boric  acid  serves  as  an 
antiseptic  dressing.  It  is  often  possible  to  cut  off  the 
projecting  nail,  and,  by  the  use  of  the  boric  acid  dressing, 
the  trouble  disappears  in  a  few  days.  Attention  should 
always  be  given  to  the  toe-nails  when  bathing. 

Corns. — There  are  two  varieties  of  corns;  both  are  very 


THE  CARE  OF  THE  SKIN  AND  ITS  APPENDAGES   79 

painful.  Soft  corns  come  between  the  toes,  and  unless 
absorbent  cotton  is  inserted  to  prevent  the  rubbing  of  the 
toes  together,  a  second  com  appears  on  the  opposing  sur- 
face of  the  adjoining  toe.  A  very  effective  remedy  for 
this  is  the  application  of  blue-stone,  or  sulphate  of  copper, 
to  the  com.  The  stone  is  moistened  in  water  and  then 
applied  thoroughly  to  the  com;  absorbent  cotton  should  be 
placed  between  the  toes.  In  very  severe  cases  it  may  be 
necessary  to  stay  off  the  feet  for  a  few  days  and  keep  the 
foot  upon  a  chair. 

Hard  corns  must  be  cut  down  with  the  greatest  care. 
It  should  be  done  directly  after  the  bath,  so  as  to  have  the 
skin  in  as  nearly  an  aseptic  condition  as  possible.  A  small 
scalpel,  composed  entirely  of  steel,  should  be  kept  for  this 
purpose.  It  must  be  thoroughly  cleaned  after  it  is  used, 
and  just  before  its  use  be  sterilized  by  boiling  for  five 
minutes.  The  reasons  for  these  precautions  are  the  pos- 
sibility of  cutting  into  the  flesh  and  setting  up  blood- 
poisoning  by  the  entrance  of  germs  into  the  wound. 

After  the  com  has  been  cut  down,  an  application  of  the 
following  prescription  will  hasten  its  disappearance.  Take 
of  the  extract  of  cannabis  indica,  15  grains;  of  salicylic 
acid,  1  dram;  and  of  flexible  collodion,  1  ounce.  Mix  well, 
and  apply  by  painting  over  with  a  camel's-hair  brush. 
The  application  should  be  repeated  every  night. 


CHAPTER  III 

THE    DIGESTIVE    SYSTEM   AND    THE   MAINTE- 
NANCE  OF   GOOD   DIGESTION 

The  Digestive  Tract;  the  Care  of  the  Mouth  and  Teeth;  Diges- 
tion a  Chemical  Process;  Digestion  in  the  Small  Intestines;  the 
Microorganisms  of  the  Alimentary  Canal;  the  Importance  of  a 
Varied  Diet;  Classification  of  Food-stuffs;  Tea,  Coffee,  and  Cocoa; 
the  Temperature  of  Foods  and  Drinks;  Factors  which  Favor  Good 
Digestion. 

Over-eating;  Dietary  in  Sedentary  Occupations;  Heart  Failure 
and  Other  Ills  as  the  Result  of  Chronic  Underfeeding;  the  Causes  of 
Indigestion;  the  Symptoms  of  Indigestion;  Intestinal  Indigestion; 
Biliousness  and  Bilious  Attacks;  Ptomain  Poisoning;  Diet  in 
Indigestion;  Treatment  of  Acute  Diarrhea;  Chronic  Intestinal 
Catarrh;  Constipation  and  Mental  Troubles;  Treatment  of  Consti- 
pation. 

The  Physiologic  Action  of  Moderate  Doses  of  Alcohol;  the  Effect 
of  Alcohol  on  the  Muscular  System;  the  Effect  of  Alcohol  on  the 
Nervous  System. 

The  activities  of  animals  are  carried  on  by  a  certain 
expenditure  of  energy,  which  is  set  free  as  the  result  of  a 
chemical  breaking  down  of  the  living  tissues  of  the  body. 
In  order  to  maintain  the  equilibrium  of  the  body,  this 
waste  must  be  replaced  by  new  material,  which  is  taken 
into  the  body  in  the  shape  of  food  and  drink. 

In  the  human  body  the  digestive  processes  are  brought 
about  by  mechanical  disintegration;  by  the  action  on  the 
food-stuffs  of  acid  and  alkaline  fluids;  by  changes  produced 
by  active  substances  called  ferments;  and,  lastly,  decom- 
position is  produced  by  the  growth  of  microorganisms. 

The  digestive  tract,  or  alimentary  canal,  begins  at  the 
mouth  and  ends  at  the  anus.  It  consists  of  the  mouth, 
the  esophagus  or  gullet,  the  stomach,  the  small  and  large 
intestines.  Two  large  glands,  the  liver  and  pancreas,  pour 
their  secretions  into  the  small  intestine  to  aid  in  the  di- 

80 


THE  DIGESTIVE   SYSTEM   AND   GOOD   DIGESTION       81 

gestion  of  foods.     The  alimentary  canal,  liver,  and  pan* 
creas  together  constitute  the  digestive  system. 


Salivary, 
glands 


Duodenum- 


Large  intes* 
tine 


Vermifonn  appendix 


Salivary 
(parotid)  gland 


Thoracic  or 
chyle  duct 

Esophagus 


Lacteals 


Small  intes- 
tine 


Rectum 


Fig.  4. — General  scheme  of  the  digestive  tract,  with  the  chief  glands 
opening  into  it  (Stockton). 


The  contraction  of  the  muscular  walls  of  the  digestive 
tract  is  the  propelling  power  that  carries  the  food  down- 
ward, while  the  contractions  of  its  pouch-like  dilatation^ 
the  stomach,  cause  churning  movements  that  bring  the 

6 


82  PERSONAL   HYGIENE   FOR  WOMEN 

food  into  contact  with  its  secretions.  These  movements 
are  known  as  the  mechanics  of  digestion. 

The  digestive  tract  is  lined  throughout  its  entire  course 
by  mucous  membrane;  that  lining  the  mouth  gives  some 
idea  of  its  character.  It  is  from  the  mucous  membrane 
lining  the  stomach  and  small  intestines,  as  well  as  from 
the  liver  and  pancreas,  that  the  digestive  juices  are  poured 
into  its  cavity. 

In  passing  downward  the  food  meets  with  five  different 
digestive  fluids:  the  saliva  in  the  mouth,  the  gastric  juice 
in  the  stomach,  and  the  bile,  pancreatic,  and  intestinal 
juices  in  the  small  intestines.  Each  digestive  fluid  acts 
only  on  some  particular  kinds  of  food.  This  action  of  the 
digestive  fluids  on  food  is  called  the  chemical  part  of  diges- 
tion. 

To-day,  when  it  is  known  that  so  many  of  the  diseases 
of  the  body  are  caused  by  germs,  it  is  evident  that  the 
greatest  care  must  be  exercised  in  the  selection  of  foods, 
in  their  preparation,  and  in  the  care  of  the  intestinal  tract. 

The  Care  of  the  Mouth  and  Teeth. — The  first  stage 
of  digestion  takes  place  in  the  mouth.  It  is  here  that  the 
food  is  ground  into  fine  particles  by  the  act  of  mastica- 
tion, so  that  it  can  be  more  easily  and  more  quickly  acted 
upon  by  the  gastric  juice. 

It  is  of  the  first  importance  that  the  mouth  should  be 
kept  clean  and  as  nearly  aseptic  as  possible ;  for,  as  the  food 
is  roUed  about  in  the  mouth  in  the  process  of  mastication, 
it  is  obvious  that  it  will  carry  all  germs  and  mucus  with 
it  into  the  stomach.  A  nasal  spray,  containing  some 
solution  of  an  alkaline  and  antiseptic  nature,  should 
form  an  essential  part  of  the  toilet  of  the  mouth. 

The  Teeth. — From  simply  an  esthetic  point  of  view, 
well-kept  teeth  are  beautiful,  and  greatly  enhance  the 
charm  of  the  face.  But  the  proper  care  of  the  teeth  is 
also  essential  to  good  digestion  and  good  health. 

In  perhaps  the  majority  of  people  the  teeth  are  suffi- 
ciently far  apart  for  small  particles  of  food  to  become 
lodged  between  them.     If  not  very  promptly  removed, 


THE    DIGESTIVE   SYSTEM   AND    GOOD   DIGESTION       83 

the  heat  and  moisture  of  the  mouth,  actmg  on  these  small 
particles,  cause  their  decomposition  and  set  up  acid  fer- 
mentation in  the  mouth,  and  it  is  this  acid  which  causes 
the  decay  of  the  enamel  and  finally  of  the  teeth.  The 
decayed  tooth  gives  still  further  lodgment  to  particles  of 
food,  and  these,  left  to  decompose,  give  rise  to  the  most 
offensive  gases,  giving  fetor  to  the  breath,  poisons  the 
blood,  and  so  injures  the  digestive  and  nervous  systems. 

WTiere  possible,  a  tooth-pick  and  dental  floss  should  be 
used  immediately  after  each  meal,  the  waxed  dental  floss 
between  the  teeth,  and  the  curved  end  of  the  tooth-pick 
being  used  to  remove  any  particles  that  may  have  worked 
in  about  the  roots  of  the  teeth  and  gums. 

A  tooth-brush  with  good  tooth-powder  should  be  used 
twice  a  day.  The  brush  should  not  be  too  broad,  and  is 
better  if  slightly  curved.  The  bristles  should  not  be  too 
hard.  The  use  of  tooth-powder,  which  must  be  very 
fine,  or  tooth-paste,  is  needed  to  produce  sufficient  fric- 
tion to  clean  the  teeth  well.  Warm  water  is  a  better 
solvent  than  cold,  and,  therefore,  it  is  well  to  use  it  for 
cleansing  the  teeth. 

T\Tiile  it  is  generally  known  that  decay  if  neglected  will 
destroy  a  tooth,  it  is  not  so  well  known  that  many  teeth 
are  lost  as  the  result  of  the  accumulation  of  tartar  at  the 
gum  margin.  There  is  a  tendency  to  this  accumulation, 
especially  about  the  necks  of  the  lower  incisors  and  upon 
the  teeth  that  are  not  used  in  chewing.  The  deposit  of 
tartar  encroaches  upon  the  neck  of  the  tooth,  presses  upon 
the  gum;  the  latter  becomes  irritated  or  inflamed,  and 
recedes  from  the  tooth ;  malnutrition  and  loosening  of  the 
tooth  follow. 

With  very  imperfect  or  decayed  teeth  proper  mastica- 
tion is  impossible. 

The  teeth  should  be  examined  by  a  good  dentist  twice  a 
year,  so  that  small  cavities  shall  be  discovered  in  an  early 
stage,  the  tartar  removed,  and  the  teeth  kept  in  their  best 
condition.  This  will  prevent  the  early  loss  of  the  teeth. 
Lost  teeth  must  be  replaced  so  that  the  teeth  shall  be 


84 


PEKSONAL  HYGIENE  FOR  WOMEN 


opposite  each  other,  and  another  important  factor  in 
mastication  is  that  the  teeth  shall  strike  properly. 

Digestion  a  Chemical   Process. — Briefly  stated,  the 
process  of  digestion  consists  in  the  liquefaction  of  the 


Fig.  5. — Location  of  the  viscera  of  the  body  and  their  relation 
to  each  other:  D,  D,  Lungs  with  air  expelled;  E,  E,  diaphragm 
cut  away  to  show,  F,  liver  cut  to  show  stomach;  2,  gall-bladder; 
H,  H,  large  iatestine;  K,  small  intestine;  L,  vermiform  appendix 
(after  Heath). 

solid  portions  of  the  food  and  the  conversion  of  the  in- 
soluble parts  into  soluble.  The  last  named  is  accom- 
plished through  the  action  of  the  digestive  ferments. 


THE  DIGESTIVE   SYSTEM  AND   GOOD   DIGESTION       85 

The  work  done  in  the  alimentaiy  canal  is  comparable 
to  that  done  in  a  chemical  laboratory.  In  order  to  effect 
the  necessary  changes  in  the  foods,  and  render  them  of  use 
in  the  body,  there  are  secreted  daily  about  three  pints  of 
saliva,  twelve  pints  of  gastric  juice,  two  or  three  pints  of 
bile,  one  pint  of  pancreatic  juice,  and  a  large  amount  of 
intestinal  juice. 

Altogether  the  amount  of  fluids  poured  into  the  ali- 
mentary canal  in  the  twenty-four  hours  is  much  more 
than  the  whole  of  the  blood  in  the  body;  and,  moreover, 
it  is  probable  that  every  portion  of  the  blood  passes  several 
times  into  the  alimentary  canal  during  this  period. 

In  other  words,  there  is  constantly  going  on  in  the  body 
between  the  blood  and  the  products  of  digestion  a  great 
ebb  and  flow;  new  substances  are  taken  up  by  the  blood 
for  the  repair  of  the  tissues,  and  the  worn-out  substances 
are  thrown  off. 

The  mouth  is  the  only  portion  of  the  digestive  canal 
which  is  under  the  control  of  the  will.  When  the  food 
is  finely  divided,  it  presents  a  much  larger  surface  for  the 
action  of  the  gastric  juice,  and  so  the  time  that  it  remains 
in  the  stomach  wiU  be  very  much  shorter  than  when  it 
is  swaUowed  in  large  chunks,  and  the  very  act  of  chewing 
increases  the  secretion  of  saliva. 

The  saliva  not  only  protects  the  mucous  membrane  of 
the  mouth,  but  it  keeps  it  free  from  all  food-particles, 
which,  if  allowed  to  remain,  would  decompose,  and  thus 
injure  the  teeth  by  the  action  upon  them  of  the  acids 
produced.  It  also  moistens  the  dry  food,  aids  in  the 
process  of  swallowing,  and  has  some  action  on  the  starchy 
substances  of  the  food.  By  the  process  of  mastication 
then  the  food  is  divided  into  small  particles  and  thor- 
oughly admixed  with  the  saliva,  until  the  whole  is  con- 
verted into  a  fine  pulp. 

The  secretion  of  saliva  is  a  reflex  one,  and  is  increased 
by  the  sight,  smell,  or  thought  of  savory  viands;  and  it 
may  be  almost  wholly  suppressed  by  a  state  of  mental 
anxiety.    Movements  of  the  jaws  without  anything  in  the 


86  PERSONAL  HYGIENE   FOR  WOMEN 

mouth  will  also  cause  a  flow  of  saliva.  Besides  favoring 
the  mechanical  part  of  digestion  and  its  slight  chemical 
action  on  starchy  foods,  saliva,  being  an  alkaline  fluid,  is 
a  distinct  stimulation  to  the  secretion  of  the  gastric 
juice. 

Fletcher  has  greatly  emphasized  the  necessity  for  thor- 
ough mastication.  He  holds  that  food  should  be  masti- 
cated until  reduced  to  a  state  of  liquefaction ;  by  this  means 
he  declares  that  a  smaller  amount  of  food  is  necessary  to 
maintain  the  health  and  efficiency  of  the  body. 

After  the  food  has  been  reduced  into  a  pulp  in  the  mouth, 
and  the  change  of  the  starches  into  sugar  has  begun,  it  is 
swallowed,  and  passes  into  the  next  compartment  of  the 
digestive  apparatus,  namely,  the  stomach. 

The  stomach  may  be  felt  at  the  lower  extremity  of  the 
breast  bone,  in  the  triangular  space  caused  by  the  di- 
vergence of  the  ribs.  It  is  a  large,  hollow,  compound 
gland,  the  walls  of  which  contain  muscle-fibers  in  addition 
to  the  tubules  which  elaborate  the  special  secretion.  Its 
cavity  is  lined  with  a  thick  mucous  membrane,  packed 
with  tubular  glands,  and  into  which  is  being  continually 
poured  out  a  complex  secretion,  which  is  called  the  gastric 
juice.  The  purpose  of  this  secretion  is  to  act  still  further 
upon  the  food,  and  this  is  assisted  by  the  churning  move- 
ments of  the  stomach,  designed  to  secure  an  intimate 
admixture  of  the  food  with  the  gastric  juice. 

The  first  flow  of  the  gastric  juice  is  set  up  by  the  sight, 
taste,  or  smell  of  food,  by  a  reflex  mechanism  similar  to 
that  of  the  saliva.  The  three  principal  active  agents  of 
the  gastric  juice  are  hydrochloric  acid,  pepsin,  the  proteo- 
lytic ferment,  and  rennin,  the  milk-curdling  ferment. 

Gastric  Digestion. — Gastric  juice  does  not  dissolve  and 
chemically  change  all  the  food  that  enters  the  stomach, 
but  acts  only  on  that  class  of  food  called  proteids.  Pro- 
teids  form  the  bulk  of  all  meat,  and  are  found  in  large 
quantity  in  eggs  and  milk.  The  new  substance  that  is 
formed  by  the  action  of  the  gastric  juice  is  highly  diffus- 
ible, that  is,  possesses  the  power  of  passing  through  animal 


THE   DIGESTIVE  SYSTEM   AND   GOOD   DIGESTION       87 

membranes,  and  does  at  once  pass  into  the  veins  and 
lymphatics  of  the  stomach. 

While  these  changes  are  taking  place  the  thick,  turbid, 
grayish-looking  liquid  is  from  time  to  time  ejected  from 
the  stomach,  accompanied  by  even  large  morsels  of  solid, 
less  digested  matter.  This  may  occur  within  a  few  min- 
utes of  food  having  been  taken,  but  the  larger  escape  from 
the  stomach  does  not  begin  till  from  one  or  two,  and  lasts 
from  four  to  five  hours  after  meals,  such  pieces  as  most 
resist  the  action  of  the  gastric  juice  being  the  last  to  leave 
the  stomach.  The  movements  of  even  a  full  stomach 
are  said  to  cease  during  sleep.  During  the  intervals  of 
digestion  the  stomach  is  quiescent  and  empty. 

An  important  role  is  played  by  the  nervous  system  over 
the  digestion  of  food,  and  a  very  practical  point  is  that  the 
secretion  of  gastric  juice  may  be  wholly  arrested  by  any 
violent  emotions.  In  the  presence  of  healthy  gastric  juice 
and  the  absence  of  any  nervous  interference,  the  question 
of  the  digestibility  of  any  food  is  determined  chiefly 
by  mechanical  conditions.  The  more  finely  divided  the 
material,  and  the  less  the  proteid  constituents  are  shelt- 
ered by  not  easily  soluble  envelopes,  the  more  rapid  the 
solution. 

Briefly,  then,  the  work  done  in  the  stomach  is  that 
meats  and  allied  substances  are  dissolved  and  transformed 
into  a  substance  that  is  capable  of  passing  through  mem- 
branes, and  does  pass  into  the  blood  at  once.  If  large 
quantities  have  been  eaten,  the  surplus  passes  into  the 
intestines,  where  its  digestion  is  completed.  Envelopes 
containing  starches  and  fats  are  dissolved,  setting  these 
bodies  free.  The  fats  are  melted  by  the  heat  of  the  stom- 
ach and  tend  to  run  together  in  large  drops,  forming  an 
imperfect  emulsion. 

As  a  general  rule,  one  hour  is  the  time  required  after  an 
ordinary  meal  for  the  first  portion  of  the  gastric  contents 
to  pass  into  the  small  intestine.  The  process  goes  on  for 
a  considerable  length  of  time,  the  pylorus  opening  in  a 
rhythmic  manner  every  five  or  ten  minutes,  until  all  the 


88 


PERSONAL  HYGIENE   FOR  WOMEN 


stomach-contents  have  passed  through.  The  larger  the 
meal  and  the  more  solid  the  contents,  the  longer  the 
process  takes.  Of  aU  the  bodies  which  make  up  the  food, 
fat  is  the  last  to  leave  the  stomach. 


m-^ 


Fig.  6. — ^The  ribs  removed,  showing  relation  of  thoracic  to  ab- 
dominal viscera:  A,  Trachea;  B,  heart;  C,  C,  lungs;  D,  liver;  E, 
stomach;  F,  small  intestine;  G,  large  intestine;  H,  bladder  (after 
Masse). 


Digestion  in  the  Small  Intestine. — Digestion  is 
completed  in  the  first  portion  of  the  small  intestine, 
called  the  duodenum.  This  forms  a  kind  of  U-shaped 
tube;  the  degree  of  distention  of  this  tube  seems  to  have 


THE  DIGESTIVE  SYSTEM  AND  GOOD  DIGESTION      89 

some  effect  in  the  emptying  of  the  stomach:  so  long  as  the 
duodenum  is  full,  no  further  escape  of  food  from  the 
stomach  takes  place. 

When  the  partially  digested  food  or  chyme  passes  into 
the  duodenum,  it  mixes  with  the  bile,  the  pancreatic,  and 
intestinal  juices  which  it  finds  there. 

The  bile  arrests  the  action  of  pepsin ;  it  assists  in  emulsi- 
fying the  fats  and  in  their  absorption;  it  exerts  an  anti- 
septic action  on  the  contents  of  the  intestinal  canal;  it 
moistens  the  coats  of  the  intestines,  and  assists  in  giving 
the  feces  their  normal  amount  of  water,  without  which 
they  cannot  readily  be  evacuated.  It  thus  acts  as  a 
natural  laxative  and  increases  the  peristaltic  action  of  the 
intestines. 

The  second  action  upon  the  food  in  the  intestine  is  that 
of  the  bicarbonate  of  soda  contained  in  the  pancreatic 
and  intestinal  juices,  which  neutralizes  its  acidity,  and 
pancreatic  digestion  can  only  take  place  in  an  alkaline 
medium. 

Pancreatic  juice  is  remarkable  for  the  power  it  possesses 
of  acting  on  all  food-stuffs,  starches,  fats,  and  proteids. 
It  contains  four  ferments — trypsin,  which  acts  energeti- 
cally on  the  proteids  which  have  passed  from  the  stomach 
unchanged;  a  diastatic  ferment,  called  amylopsin,  which 
converts  starch  into  sugar;  a  ferment  which  acts  upon  fats; 
and  another  ferment,  which  acts  upon  milk,  curdling  it. 

It  is  probable  that  when  proteids  are  taken  in  excess 
they  undergo  pancreatic  digestion,  and  it  is  quite  possible 
that  this  pancreatic  digestion  of  an  excess  of  proteids  is 
accompanied  by  a  considerable  development  of  bacteria 
and  other  organized  bodies,  which  create  trouble  by  in- 
ducing fermentative  changes  in  the  accompanying  sac- 
charine contents  of  the  small  intestine. 

The  digested  substances  pass  directly  from  the  small 
intestine  into  the  lymphatics  and  blood-vessels.  Since 
the  amount  of  secretions  from  the  small  intestines  is 
almost  as  great  as  the  amount  of  absorption  from  it,  the 
contents  remain  hquid  throughout  its  course.    The  nutri- 


90  PERSONAL  HYGIENE   FOR  WOMEN 

tive  elements  are  all  absorbed  before  the  large  intestine 
is  reached.  Here,  owing  to  the  absorption  of  water, 
the  contents  become  converted  into  solid  feces,  which 
shift  in  color  from  a  bright  orange  to  a  dirty  brown. 
When  the  bile  is  cut  off  from  the  intestines,  the  feces 
become  clay-colored  and  constipation  results. 

When  digestion  ceases,  there  is  a  cessation  of  contrac- 
tions, and  the  mucous  membrane,  which  was  deep  red 
and  congested,  now  becomes  grayer,  and  the  whole 
intestine  is  restored  to  a  condition  of  repose. 

The  Microorganisms  of  the  Alimentary  Canal. — 
Large  numbers  of  bacteria  flourish  in  the  mouths  of  all 
animals,  especially  around  the  base  of  the  teeth,  and  form 
a  large  part  of  the  tartar. 

In  the  great  majority  of  cases  uncooked  food  contains 
a  large  number  of  microorganisms.  Raw  food,  especially 
that  which  is  green,  carries  with  it  into  the  alimentary 
canal  a  large  number  of  bacteria.  Also  meats,  which 
have  been  kept  too  long,  and  foods  which  have  been  in- 
sufficiently preserved,  contain  a  large  number  of  fungi, 
which  are  thus  introduced  into  the  body.  Thoroughly 
cooked  food,  eaten  hot,  carries  with  it  into  the  body 
very  few  bacteria. 

The  normal  mucous  membrane  of  the  intestines  ap- 
pears to  constitute  one  of  the  bulwarks  which  defends  the 
animal  organism  from  outside  infective  agents. 

The  Importance  of  a  Varied  Diet. — It  is  known  that 
for  a  healthy  adult  a  mixed  diet  is  essential,  and  a  very 
important  fact,  which  has  only  recently  been  discovered, 
is  that  habits  of  digestion  may  be  formed;  that  is,  each 
food  only  calls  forth  a  supply  of  those  ingredients  of  the 
digestive  juices  especially  required  for  its  own  digestion. 
For  instance,  if  the  child  is  encouraged  to  avoid  fats,  he 
may  ultimately  lose  the  power  of  producing  secretion 
especially  suited  for  the  digestion  of  fatty  foods,  and 
may  thus,  with  the  best  intentions,  be  unable  to  eat  fats 
all  the  rest  of  his  life,  and  so  suffer  from  impaired  nutri- 
tion.    This  is  the  more  to  be  regretted  as  there  is  reason 


THE   DIGESTIVE   SYSTEM  AND   GOOD   DIGESTION       91 

to  believe  that  the  inability  to  digest  fats  renders  one 
peculiarly  liable  to  become  the  victim  of  tuberculosis. 

Classification  of  Food-stuffs. — There  are  five  classes 
of  food-stuffs:  the  organic,  comprising  proteids  or  albu- 
minous food-stuffs,  carbohydrates  and  fats,  mineral  salts, 
and  water. 

All  vegetable  and  animal  food,  whatever  their  nature, 
and  whatever  their  origin,  are  composed  simply  of  repre- 
sentatives of  proteids,  carbohydrates,  and  fats. 

Proteids  are  a  source  of  energy,  and  contribute  to  form 
and  to  keep  up  the  primary  active  protoplasm  of  cells  and 
their  accessory  or  inactive  constituents.  Fats  are  also 
sources  of  energy  and  may  supply  a  portion  of  inactive 
material  composing  cells.  Carbohydrates  have  a  similar 
function  to  that  of  fats.  The  mineral  salts  are  not  pro- 
ducers of  energy  in  the  body,  but  are  indispensable,  both 
for  the  active  or  protoplasmic  part  and  for  the  inactive 
framework  of  the  cell.  Water  acts  as  a  general  solvent, 
and  is  a  necessary  agent  for  the  various  metabolic  proc- 
esses. 

Proteids,  water,  and  mineral  salts  are  absolutely  neces- 
sary for  the  preservation  of  the  life  of  animals.  Proteid 
substances  can  be  so  altered  in  the  body  as  to  supply 
both  the  fats  and  the  carbohydrates  when  required. 
Fats  and  carbohydrates  alone  are  not  sufficient  to  support 
life,  but,  if  these  two  classes  of  foods  be  given  along  with 
proteids,  they  diminish  the  amount  of  albuminous  food 
necessary. 

Animal  food  is  believed  to  make  the  blood  richer  in 
fibrin  and  corpuscles  and  to  increase  the  mineral  salts, 
especially  the  phosphates.  It  makes  the  muscles  firmer 
than  they  were  under  a  vegetable  diet,  and  it  favors  the 
reduction  of  superfiuous  fat.  It  increases  the  urates 
and  urea,  and  tends  to  make  the  fluids  of  the  body  more 
acid.  It  increases  the  functional  activity  and  the  resist- 
ing power  of  the  body.  On  the  other  hand,  an  increased 
animal  diet  necessitates  an  increased  amount  of  oxygen 
for  its  proper  burning  up  in  the  system.    Meat  is  more 


92  PERSONAL  HYGIENE  FOR  WOMEN 

stimulating  and  strengthening  than  vegetable  foods,  and 
gives  rise  to  a  feeling  of  energy. 

When  meat-eating  is  not  counterbalanced  by  a  proper 
amount  of  exercise  in  the  open  air,  an  excess  of  waste 
matter  is  produced,  which  accumulates  in  the  system 
and  causes  biliousness  and  an  excess  of  uric  acid,  which 
may  lead  to  rheumatism,  gout,  etc. 

The  generally  accepted  estimate  is  that  meat  should 
form  one-fourth  and  vegetables  three-fourths  of  the  diet. 

A  man  cannot  perform  more  muscular  labor  on  an 
exclusively  meat  diet  than  on  one  of  starches,  but  he 
does  require  animal  food  to  replace  the  general  wear  and 
tear  of  the  muscular  tissues;  energy  for  muscular  contrac- 
tions is  provided  by  the  non-nitrogenous  foods  or  carbo- 
hydrates. Meats  give  strength,  but  the  carbohydrates 
furnish  the  endurance  which  is  needed  for  prolonged 
strain. 

The  amount  of  food  for  the  twenty-four  hours  has  been 
estimated  as  rather  more  than  one  pound  of  fresh  meat, 
one  pound  each  of  bread  and  potatoes,  or  their  equivalent 
in  other  starchy  foods,  with  a  quarter  of  a  pound  of  butter, 
lard,  and  suet,  and  three  pints  of  water. 

But  were  these  same  articles  of  diet  placed  on  the  table 
every  day,  cooked  in  precisely  the  same  way,  the  appetite 
would  soon  cloy,  and  the  individual  would  be  incapable  of 
eating  enough  food  to  properly  do  the  normal  amount  of 
work. 

So  it  becomes  necessary  that  certain  articles  belonging 
to  the  same  class  should  be  varied  from  day  to  day,  with 
the  greatest  possible  variety  in  the  preparation  of  the  same 
dishes. 

Preparation  of  Food. — Fresh  meats  are  highly  nutri- 
tious, but,  in  order  that  the  nutritive  properties  should  not 
be  lost  in  the  cooking,  they  must  be  eaten  "  rare,"  that  is, 
beef  and  mutton  should  be  at  least  pink. 

A  roast  should  be  done  in  a  quick  oven,  so  that  the 
albumin  will  rapidly  coagulate  on  the  surface  and  prevent 
the  escape  of  the  nutritive  juices.     Or,  if  the  meat  is 


THE  DIGESTIVE   SYSTEM   AND   GOOD  DIGESTION       93 

boiled,  it  should,  for  the  same  reason,  be  plunged  into 
boiling  water. 

On  the  other  hand,  in  treating  meats  in  order  to  obtain 
"stock"  for  soup,  cold  water  should  be  used,  and  the  tem- 
perature slowly  raised,  but  not  quite  to  the  boiling-point, 
in  order  that  as  much  as  possible  of  the  soluble  ingre- 
dients may  be  extracted. 

Eggs  are  almost  as  nutritious  as  meat.  They  are  most 
easily  digested  when  soft-boiled  or  poached.  Dry  toast, 
finely  broken  up  and  mixed  with  a  soft-boiled  egg,  aids 
in  its  digestion.  Soft-boiled  eggs  are  more  easily  digested 
than  raw  eggs,  but  raw  eggs  are  less  irritating  to  the 
stomach,  probably  because  they  are  digested  in  the  in- 
testine. 

Fresh  Meats. — The  breast  of  chicken,  fresh  beef,  and 
mutton  are  among  the  most  easily  digested  of  the  solid 
foods.  Raw  and  rare  meats  are  more  easily  digested  than 
well-done  meats;  in  other  words,  cooking  lessens  the 
digestibility  of  meats.  Veal  and  pork  are  both  very 
dijB&cult  of  digestion.  Steak  should  be  broUed  and  never 
fried;  all  fried  foods  are  very  difficult  to  digest. 

Milk  is  the  most  digestible  of  aU  foods  if  consumed  in  a 
reasonable  way.  The  addition  of  Vichy  or  lime-water 
renders  the  milk  less  liable  to  form  tough  clots,  hence 
renders  it  more  digestible.  Boiled  milk  is  more  digestible 
than  raw  milk ;  boiling  increases  the  toughness  of  the  curd, 
but  it  destroys  all  bacteria. 

Milk  is  a  fluid  only  outside  of  the  body;  when  it  enters 
the  stomach,  it  is  converted  by  the  rennin  into  a  solid  clot; 
the  clot  formed  in  the  stomach  of  infants  is  much  less  firm 
and  more  easily  digested.  Anything  which  will  prevent 
the  formation  of  this  clot  will  hasten  its  digestion.  The 
milk  should  be  sipped  slowly,  and  not  a  tumblerful  gulped 
down  at  a  swallow.  Bread  or  cracker,  broken  up  in  the 
milk,  aids  in  its  digestion;  also  the  addition  of  equal  parts 
of  barley  or  aerated  waters.  Buttermilk  and  kumiss  are 
more  easily  digested  than  cow's  milk.  A  glass  of  milk  is 
digested  in  about  two  hours. 


94  PERSONAL  HYGIENE  FOR  WOMEN 

Vegetables  differ  from  aniraal  food  in  containing  a  much 
greater  proportion  of  material  which,  for  man,  is  indi- 
gestible and  much  less  nutritive  material.  Vegetables 
and  fruits  are  both  rendered  more  digestible  by  cooking. 

Cane-sugar,  especially  in  strong  solution,  is  an  irritant 
to  the  stomach.  The  liver  makes  all  the  sugar  that  is 
needed  in  the  system  when  none  is  taken  in  the  food. 
In  addition  to  this,  all  the  starch  that  is  taken  as  food  is 
converted  into  sugar  in  the  body.  Many  foods  contain 
sugar,  as  honey,  molasses,  milk,  raisins,  dates,  figs,  and, 
indeed,  all  kinds  of  fruit. 

When  sugar  is  taken  in  excess,  it  undergoes  fermenta- 
tion in  the  alimentary  canal,  being  converted  into  alcohol, 
carbonic  and  acetic  acids.  This  fermentation  and  its 
products  impede  the  work  of  the  liver,  make  the  system 
run  with  friction,  prevent  the  elimination  of  effete 
products,  and,  after  long-continued  use,  cripple  all  the 
processes  of  life. 

Butter  suppUes  to  most  people  the  largest  amount  of  fat 
they  take,  but  its  use  should  be  supplemented  with  the 
fats  of  fresh  meat  and  of  bacon.  It  is  easily  digested  by 
most  persons,  except  when  it  is  rancid;  it  then  causes 
dyspepsia  and  diarrhea.  As  a  rule,  it  may  be  said  that 
decomposing  fats  of  all  kinds  disagree  with  the  system. 

Common  salt  in  moderate  quantity  is  essential  to  the 
economy,  but  its  excessive  use  is  harmful.  All  highly 
spiced  or  seasoned  foods  should  be  avoided.  Condiments 
improve  the  appetite,  but  they  are  irritating  to  the 
stomach,  and  should  be  eaten  sparingly. 

Vinegar. — The  acid  of  vinegar,  being  a  fermentation 
acid,  renders  the  digestion  of  many  foods  with  which  it  is 
taken  more  difficult,  while  vegetable  acids,  such  as  lemon- 
juice  and  citric  or  tartaric  acid,  do  not  cause  that  ob- 
jectionable effect.  Thus,  cucumber  salad,  made  with  the 
vegetable  freshly  cut,  w^hen  dressed  with  vinegar,  is  so 
difficult  of  digestion  as  to  be  for  many  persons  almost 
poisonous;  whereas  if  lemon-juice  is  used  instead  of  vine- 
gar in  the  dressing,  it  can  be  easily  and  comfortably 


THE   DIGESTIVE   SYSTEM   AND   GOOD   DIGESTION       95 

digested  by  the  same  persons.  Vinegar  retards  salivary- 
digestion  and  the  digestion  of  those  carbohydrates  with 
which  it  is  combined. 

Tea,  coffee,  and  cocoa  all  retard  gastric  digestion. 
Cocoa  is  the  most  nutritious.  Both  tea  and  coffee  are 
pure  stimulants.  Coffee  should  never  be  taken  more 
than  twice  a  day,  and  the  amount  should  be  limited  to 
one  cupful  of  coffee  at  breakfast  and  a  demi-tasse  after 
dinner.  Its  well-known  power  as  a  brain  stimulant  leads 
to  drinking  it  in  excess;  it  then  seriously  interferes  with 
digestion,  and  its  continuous  excessive  use  may  lead  to 
chronic  dyspepsia  and  insomnia. 

The  amount  of  harm  done  by  tea  depends  to  a  great 
extent  on  the  way  in  which  it  is  made  and  the  quantity 
which  is  taken. 

Tea  improperly  made  is  capable  of  doing  so  great  an 
amount  of  harm  to  the  digestive  and  nervous  systems 
that  emphasis  must  be  laid  on  the  necessity  of  making  it 
properly. 

The  Prcper  Method  of  Making  Tea. — The  water  should 
be  freshly  boiled ;  the  tea-pot  heated,  so  that  the  water  will 
be  maintained  at  the  boiling-point ;  one  teaspoonful  of  tea 
is  allowed  to  the  cup.  The  tea  is  measured  out,  put  in  the 
tea-pot,  and  the  requisite  amount  of  boiling  water  poured 
over  it.  It  is  then  allowed  to  stand  on  the  kitchen  table, 
not  the  range,  from  two  to  three  minutes,  and  should  then 
be  strained  into  the  tea-pot  for  the  table  and  served. 
Unless  the  tea-leaves  are  strained  off,  the  infusion  contin- 
ues for  some  time;  this  extracts  the  tannic  acid  and  the 
bitter  principles.  In  addition,  the  prolonged  infusion 
dissipates  the  volatile  oil,  to  which  much  of  the  fragrance 
of  a  good  cup  of  tea  is  due.  As  it  is  almost  impossible  to 
have  the  requisite  amount  of  care  exercised  in  the  making 
of  tea  in  the  kitchen,  it  is  much  better  that  it  should  be 
made  on  the  table.  Sugar  detracts  from  the  healthfulness 
of  the  beverage. 

Water  constitutes  about  two-thirds  of  the  weight  of  the 
body,  so  that  water  is  both  a  tissue-builder  and  a  food. 


96  PERSONAL  HYGIENE  FOR   WOMEN 

About  4|  pints  of  water  are  given  off  daily  in  the  form  of 
the  various  excreta  and  exhalations,  but,  since  about  one- 
half  of  the  solid  foods  taken  consist  of  water,  3  pints  of 
water  taken  as  such  is  sufficient  to  counterbalance  the  loss. 

The  Temperature  of  Foods  and  Drinks. — The  ideal 
temperature  of  food  and  drinks  is  about  that  of  the  body 
itself.  Gold  food  is  difficult  to  digest,  for  it  does  not 
excite  the  stomach  sufficiently,  nor  does  it  possess  the 
stimulating  properties  of  a  hot  meal. 

Extremes  of  temperature  in  foods  should  be  avoided, 
as  tending  to  produce  local  injury  to  the  stomach;  from 
45°  to  130°  F.  are  probably  the  limits  of  safety. 

Drinks  at  a  temperature  of  122°  F.  are  sufficient  to 
wann  the  body,  and  a  temperature  of  45°  F.  is  sufficient  to 
cool  it.  In  both  extremes  there  is  danger  of  exciting 
gastric  catarrh.  The  temperature  best  suited  to  quench 
the  thirst  is  from  50°  to  70°  F.  Ices  should  be  avoided, 
as  they  may  cause  dyspepsia,  neuralgia  about  the  heart, 
and  even  acute  dilatation  of  the  stomach. 

Factors  which  Favor  Good  Digestion. — The  stomach 
acts  as  a  reservoir,  and  renders  the  taking  of  meals  pos- 
sible. The  capacity  of  the  stomach  varies  in  different 
individuals;  it  contains  from  2  to  4  pints  of  liquids,  or 
about  2  pounds  of  solids.  The  process  of  digestion  con- 
tinues from  about  four  to  five  hours;  by  the  end  of  that 
time  the  stomach  is  empty. 

This  gives  us  a  very  useful  hint  as  to  the  length  of  time 
that  must  elapse  between  meals.  If  a  fresh  meal  is  intro- 
duced into  the  stomach  before  it  has  had  time  to  empty 
itself,  the  process  of  digestion  is  started  afresh,  and  the 
stomach  is  robbed  of  the  necessary  rest  between  •  two 
periods  of  activity. 

As  a  rule,  three  meals  a  day  has  been  found  to  be  the 
best  arrangement,  and  there  should  be  an  interval  of  five 
hours  between  meals.  If  possible,  dinner,  which  is  the 
principal  meal  of  the  day,  should  be  taken  at  the  end  of  the 
day,  after  its  work  is  over,  so  that  comparative  repose 
may  be  enjoyed  after  it.    The  meals  must  be  served  at 


THE  DIGESTIVE   SYSTEM  AND   GOOD  DIGESTION       97 

the  same  hour  every  day.  The  perfectly  healthy  woman 
should  never  take  anything  to  eat  between  meals. 

Gentle  exercise  may  aid  digestion,  while  severe  exercise, 
by  diverting  much  blood  and  nervous  energy  to  the  mus- 
cles, would  have  an  adverse  effect.  Sleep  directly  after  a 
hearty  meal  is  injurious  and  sometimes  proves  fatal, 
because  there  is  a  depression  of  the  circulation,  and  the 
digestive  processes  may  stop  absolutely  during  sleep. 
The  best  employment  after  a  hearty  meal  is  frivolous 
conversation,  which  keeps  the  heart  alive,  without  making 
too  great  demands  on  the  brain. 

A  hearty  meal  should  never  be  eaten  when  one  is  ex- 
hausted or  greatly  fatigued.  Half  an  hour's  rest  before 
dinner  is  a  great  aid  to  digestion. 

Certain  conditions  are  imperative  in  order  to  maintain 
a  healthy  state  of  the  digestive  organs  and  of  the  body. 
These  are  both  physical  and  psychic.  A  good  caterer, 
a  good  cook,  a  cheerful  frame  of  mind,  and  the  proper 
leisure  to  eat  the  meal  are  all  essential  factors. 

The  influence  of  the  psychic  on  the  process  of  digestion 
has  not  been  sufficiently  well  understood.  It  is  intimately 
bound  up  with  the  sensations  of  appetite  and  hunger. 
Appetite  is  the  most  powerful  excitant  of  the  gastric 
juice.  Hence  the  importance  for  digestion  of  such  im- 
portant aids  to  appetite  as  agreeable  surroundings,  a  well- 
appointed  table,  and  good  cooking. 

A  very  practical  point  is  that  gastric  secretions  may  be 
whoUy  arrested  by  violent  emotions.  On  the  completion 
of  a  hearty  meal,  which  has  been  eaten  with  the  greatest 
relish,  the  arrival  of  a  telegram  containing  the  intelligence 
of  the  death  of  a  friend  or  of  a  heavy  financial  loss  causes 
the  dinner  to  lay  like  lead  on  the  stomach.  This  shows 
the  important  role  played  by  the  nervous  system  over  the 
secretion  of  the  digestive  juices. 

Water. — With  the  proper  mastication  of  the  food  there 
will  be  less  desire  to  drink  water  during  the  meal;  a  glass 
of  water  should  be  slowly  taken  at  the  end  of  the  meal. 

Water  is  not  absorbed  by  the  stomach,  but  passes 
7 


98  PERSONAL  HYGIENE   FOR  WOMEN 

directly  into  the  small  intestine.  A  pint  of  hot  water 
escapes  into  the  intestiae  in  about  three-quarters  of  an 
hour  after  it  is  taken.  Hot  water  has  a  powerful  stimulat- 
ing effect  on  the  peristalsis  of  the  stomach,  and  so  is  a  very 
material  aid  to  sluggish  digestion.  It  should  be  taken  one 
hour  before  meals,  so  as  to  wash  out  the  stomach,  and  not 
to  fill  it  up  at  the  time  the  meal  is  taken. 

Water  is  a  very  dangerous  vehicle  for  infection.  The 
only  sure  method  of  rendering  water  harmless  is  by  boiling. 
The  addition  of  a  little  wine  or  even  spirits  does  not  destroy 
the  germs. 

The  mineral  waters  promote  digestion,  by  causing  an 
earlier  and  more  abundant  secretion  of  the  gastric  juice. 

Defecation. — The  waste  matter  which  collects  in  the 
lower  bowel  must  be  evacuated  every  day.  Allowed  to 
remain  longer  than  this,  the  digestive  system  is  clogged  by 
the  non-removal  of  worn-out  material,  and  the  blood  is 
constantly  absorbing  matter  which  is  poisonous  to  the 
body.  Decomposition  goes  on  without  being  suspected 
by  the  sufferer. 

Overeating. — It  is  generally  recognized  that  mental 
efficiency  is  very  dependent  on  bodily  conditions.  The 
question  how  best  to  maintain  the  body  in  its  highest 
degree  of  efficiency  becomes  a  vital  one  to  every  person. 

Professor  Chittenden,  of  Yale  University,  one  of  the 
foremost  physiologists  of  the  day,  as  the  result  of  scientific 
experimentation  carried  on,  on  himself,  on  professional 
men,  on  a  group  of  university  athletes,  and  on  a  squad  of 
United  States  soldiers,  reached  the  following  conclusions: 
that  men  eat  far  too  much,  that  incalculable  energy  is 
wasted  by  our  bodies  in  getting  rid  of  the  surplus  food, 
that  overeating  causes  a  host  of  needless  ailments,  and 
that  better  health,  increased  efficiency,  and  enhanced 
probabilities  of  longevity  would  certainly  follow  the  general 
adoption  of  a  dietary  standard,  calling  for  not  more  than 
one-half  the  proteid  food  which  common  custom  has 
established  as  the  general  standard.  He  is  convinced  that 
we  eat  too  much  and  that  we  eat  too  rapidly. 


THE   DIGESTIVE  SYSTEM   AND   GOOD  DIGESTION       99 

Obese  patients  grow  fat  because  they  overeat,  but  with 
a  thorough  mastication  of  the  food  their  appetites  would 
be  satisfied  with  far  less  food  than  they  have  been  ac- 
customed to  eat  and  the  superfluous  fat  would  drop  off. 

Thorough  mastication  is  also  useful  to  thin  persons, 
who  have  been  in  the  habit  of  bolting  their  food,  and  have 
gotten  indigestion  as  the  result.  They  eat  less  food  under 
this  system,  but  they  get  fat  under  it. 

When  such  an  excess  of  proteids  is  taken  into  the  body 
that  it  cannot  be  disposed  of  in  the  ordinary  process 
of  oxidation  or  burning  up,  there  are  solid  chunks  of 
unburned  material  that  must  be  gotten  rid  of  by  the  liver 
and  kidneys,  which  is  injurious  to  them.  As  a  result,  the 
liver  and  kidneys  are  overworked  in  their  efforts  to  rake 
down  the  ash  produced  by  the  combustion  of  proteids 
within  the  body,  and  eventually  are  not  able  to  dispose 
of  the  surplus;  gastro-intestinal  disturbances,  bilious 
attacks,  gout,  rheumatism,  and  other  diseases  follow. 

The  chief  factors  leading  to  overeating  are  the  uses  of 
wines  and  condiments  at  dinner  and  elaborate  course 
dinners.  The  first  two  overstimulate  the  appetite,  and 
the  great  variety  offered  by  the  latter  tempt  the  appetite, 
and  make  it  possible  to  eat  more  than  one  could  if  the  bill 
of  fare  were  more  limited  and  simple. 

Dietary  in  Sedentary  Occupations. — The  important 
considerations  in  the  question  of  a  diet  are  what  to  eat, 
how  to  eat,  and  how  much  to  eat.  The  appetite  is  not  a 
safe  guide  in  very  many  cases,  because  persons  engaged 
in  sedentary  occupations,  who  take  next  to  no  outdoor 
exercise,  are  frequently  in  a  run-down  condition  and  have 
very  poor  appetites. 

It  is  not  that  the  average  woman  eats  too  much,  but 
that  she  does  not  eat  the  right  kind  of  things.  She  eats 
too  little  fresh  meat  and  eggs,  and  drinks  too  little  milk. 
She  eats  very  much  too  much  sweets,  in  the  form  of  pastry, 
cake,  or  candy,  and  the  lunch  is  not  sufficiently  nourish- 
ing. 

The  age  and  occupation  of  the  individual  are  important 


100  PEESONAL  HYGIENE   FOR  WOMEN 

factors  to  be  taken  into  consideration  in  making  out  the 
dietary. 

The  following  dietary  has  proved  to  be  the  most  satis- 
factory for  women  having  no  occupation  or  a  sedentary 
one.  On  it  women  have  maintained  good  health,  and 
many  other  women  have  recovered  their  health. 

Breakfast. — Fruit,  bacon  and  eggs,  breakfast  hominy, 
rolls  or  toast  and  butter,  a  glass  of  milk,  and  one  cup  of 
coffee. 

The  fruit  may  be  any  raw  fruit  in  season,  except  apples 
or  bananas;  apples  should  always  be  cooked  for  breakfast, 
because  they  are  more  easily  digested;  bananas  are  too 
heavy  and  indigestible  to  be  served  for  breakfast.  Stewed 
prunes  are  good  and  especially  laxative. 

Bacon  is  not  a  necessity,  though  it  is  an  appetizer. 
Eggs  may  be  served  in  any  way,  but  they  are  most  diges- 
tible if  soft-boiled  or  poached. 

The  hominy  is  boiled  in  water  and  served  as  a  vege- 
table, with  a  little  salt  and  butter,  but  no  sugar. 

It  will  be  noted  that  the  cereal  so  generally  served  for 
breakfast  is  omitted.  The  only  excuse  for  eating  a  cereal 
is  plenty  of  sugar  and  good  cream.  The  cream  can  be 
taken  in  the  milk,  and  the  amount  of  sugar  used  is  apt  to 
cause  fermentation.  The  whole  forms  a  coating  over  the 
walls  of  the  stomach,  which  prevents  the  action  of  the 
gastric  juice  on  the  rest  of  the  food.  In  addition  to  this, 
after  the  cereal  is  eaten  the  appetite  is  generally  gone. 
It  is  difficult  of  digestion,  and  should  only  be  eaten  by 
those  who  take  a  great  deal  of  outdoor  exercise. 

Luncheon. — Hamburg  steak,  or  a  made  dish  from  the 
meat  left  over  from  the  previous  day's  dinner,  creamed 
potatoes,  stewed  fruit,  bread  and  butter,  a  glass  of  milk, 
and  one  cup  of  tea.  Oysters  served  up  in  a  variety  of 
ways  make  an  appetizing  dish  for  luncheon. 

Dinner. — Soup  should  always  be  served  except  in  very 
hot  weather.  A  roast  or  other  substantial  fresh  meat, 
two  vegetables,  a  salad,  fruit,  or  a  made  dessert  with  cake, 
a  demi-tasse  of  coffee  after  dinner.     A  glass  of  water  is 


THE  DIGESTIVE  SYSTEM   AND  GOOD   DIGESTION     101 

served  with  each  meal;  it  should  be  taken  after  the  meal  is 
finished,  and  one  glass  is  as  much  as  should  be  taken. 

Vinegar  should  never  be  placed  on  the  table,  nor  be 
used  in  salad  dressings,  for  reasons  which  have  already 
been  given. 

For  a  French  dressing,  lemon-juice  should  be  substi- 
tuted for  vinegar.  The  following  are  the  correct  pro- 
portions: take  one  tablespoonful  of  lemon-juice,  one 
tablespoonful  of  water,  and  two  tablespoonfuls  of  oHve 
oil.     Mix  well,  and  pour  over  the  salad  just  before  serving. 

The  greatest  variety  possible  in  the  menu  from  day  to 
day  is  advised,  but  not  any  greater  variety  for  the  daily 
meals  than  that  given  above. 

Heart  Failure  and  Other  Ills  as  the  Result  of 
Chronic  Underfeeding. — A  long-continued  deficiency 
of  food  or  improper  kinds  of  food  leads  eventually  to 
general  malnutrition,  anemia,  and  finally  to  failure  of  the 
heart  itself.  At  first  the  muscles  of  the  heart  and  cells 
of  the  brain  are  nourished  at  the  expense  of  other  struc- 
tures, from  which  a  definite  daily  quantity  is  taken  to 
provide  their  supplies  of  albumin,  but  there  comes  a  time 
when  these  organs  also  suffer. 

DebiHty  from  underfeeding  comes  on  so  insidiously 
that  it  is  often  far  advanced  before  being  recognized  by 
the  sufferer.  Frequently  it  is  only  by  comparing  the 
present  condition  with  that  of  six  months  ago,  and 
noting  the  greatly  decreased  power  of  endurance,  that  the 
woman  realizes  that  something  must  be  wrong.  Further, 
this  condition  constitutes  part  of  a  vicious  circle ;  with  the 
decline  of  strength,  there  is  often  a  decline  of  appetite, 
which  leads  to  a  further  loss  of  both,  and  a  more  or  less 
decided  collapse  eventually  occurs. 

This  underfeeding  may  have  occurred  as  a  result  of 
ignorance,  or  from  an  ill-advised  dieting  for  disease,  as, 
for  instance,  rheumatism  or  gout,  or  from  poverty. 

An  expression  often  employed  by  this  class  of  sufferers 
is  that  they  have  "lost  heart."  It  is  believed  by  some 
authorities  that  this  depressed  feeling  is  caused  by  the 


102  PERSONAL  HYGIENE   FOR  WOMEN 

fact  that  the  heart  muscle  is  at  last  sharing  with  the  other 
muscles  in  the  general  malnutrition.  As  a  result  of  this, 
the  heart  probably  fails  and  dilates,  and  is  perhaps  never 
again  able  to  keep  up  the  same  blood-pressure,  to  produce 
the  same  muscular  nutrition,  and  the  former  strength  of 
muscle,  nerve,  and  will-power.  A  nutritious  diet  and  rest 
with  massage  are  the  best  means  to  restore  as  far  as  pos- 
sible the  ill  effects  of  such  a  condition. 

Two  points  stand  out  boldly  in  this  connection.  In  the 
first  place,  there  must  be  sufiicient  proteid  food  ingested 
to  protect  the  organism  from  body  loss;  and,  secondly, 
there  must  be  a  sufiicient  heat  value  in  the  fats  or  carbo- 
hydrates to  protect  the  body  fat  of  the  person  and  so 
prevent  emaciation.  In  regard  to  the  proteid  require- 
ment, it  has  been  found,  by  investigation,  that  about 
300  gm.  of  meat  per  day  is  necessary. 

In  this  state  of  the  system  there  is  a  weakening  of  the 
digestive  organs;  the  more  their  nutrition  fails  through 
not  eating,  the  less  they  are  able  to  digest.  This  is  often 
seen  in  dyspepsia,  and  the  first  step  in  the  cure  is  to  com- 
pel them  to  eat  more. 

The  tubercle  bacillus  seems  to  find  a  particularly 
favorable  soil  in  ill-nourished  persons.  The  association 
between  bad  feeding  and  scrofula  is  weU  established,  and 
an  improvement  in  nutrition  is  often  followed  by  their 
cure. 

Another  danger  of  underfeeding  is  the  effect  on  the 
mind.  There  is  not  only  a  lowering  of  the  mental  power, 
but  a  feeling  of  dissatisfaction,  discomfort,  depression, 
culminating  sometimes  in  hallucinations  and  insanity, 
which  imperfect  nutrition  of  the  mind  is  apt  to  produce. 
A  hungry  man  is  an  angry  man. 

Deficient  diet,  like  all  morbid  conditions,  both  corporeal 
and  mental  causes  a  vitiating  and  degenerating  infiuence. 
Famine  is  naturally  the  mother  of  crimes  and  vices,  not 
onty  of  such  sort  as  will  satiate  the  gnawing  desire  for 
food,  but  of  general  violence  and  lawlessness,  ill  temper, 
avarice,  lust,  and  cruelty. 


THE  DIGESTIVE   SYSTEM   AND   GOOD    DIGESTION      103 

The  love  of  purposeless  destruction,  exhibited  by  the 
Parisian  communists  in  our  own  day,  may  be  fairly 
credited  to  deficient  food.  No  well-fed  people  could  have 
wrecked  the  Vendome  Column,  or  burnt  the  Town  Hall 
and  the  Tuileries,  of  which  they  were  so  proud.  "They 
were  like  hungry  children  smashing  their  dolls." 

The  Causes  of  Indigestion. — Normally,  the  process 
of  digestion  is  effected  unconsciously;  the  individual  is 
not  aware  that  she  has  a  stomach.  It  may  be  accepted 
as  an  axiom,  that  when  any  organ  or  any  part  of  the  body 
persistently  obtrudes  itself  on  the  attention  of  the  owner, 
there  is  some  abnormal  or  pathologic  condition  present. 

Some  of  the  more  prominent  causes  of  indigestion  are: 
imperfect  mastication,  septic  stumps  of  teeth,  an  excessive 
quantity  of  food,  improper  kinds  of  food,  food  taken  at 
too  frequent  intervals,  alcohol,  tea,  and  coffee,  and  ex- 
haustion of  the  nervous  system. 

Imperfect  Mastication. — Defective  teeth  are  responsible 
for  much  imperfect  mastication  of  food.  The  opposing 
teeth  may  have  been  lost,  or  soreness  of  the  gums  or 
sensitive  teeth  may  prevent  the  act  of  mastication  from 
being  properly  performed. 

When  the  food  is  not  sufficiently  well  subdivided,  the 
saliva  and  gastric  juice  cannot  mix  properly  with  it, 
gastric  digestion  will  be  retarded  on  account  of  the  small 
area  of  food  presented,  and  the  prolonged  stay  of  food  in 
the  stomach  increases  the  opportunities  for  fermentation. 
Since  chewing  is  one  of  the  chief  excitants  of  the  flow  of 
saliva,  it  is  much  better  that  the  work  should  be  done  in 
the  mouth  than  in  the  kitchen. 

Septic  Teeth. — As  a  result  of  these,  microorganisms  may 
be  swallowed  with  the  food  and  act  injuriously  on  the 
stomach.  They  may  irritate  the  mucous  membrane  and 
set  up  a  chronic  gastritis,  or  these  bacteria  may  cause  a 
fermentative  process  in  the  stomach. 

An  excessive  quantity  of  food  may  produce  symptoms 
by  its  bulk  in  several  ways :  it  may  so  distend  the  stomach 
as  to  give  rise  to  sensations  of  weight,  fullness,  and  pain; 


104  PERSONAL  HYGIENE   FOR  WOMEN 

or  the  amount  of  food  taken  may  be  in  excess  of  the  powers 
of  the  gastric  juice  to  digest,  and  digestion  in  the  stomach 
may  be  so  prolonged  that  the  stomach  cannot  empty 
itself  before  the  next  meal;  or  the  bulk  of  food  may  be  so 
excessive  as  to  mechanically  impede  the  movements  of 
the  stomach;  or  excessive  bulk  of  a  vegetable  nature  will 
interfere  with  its  own  digestion,  by  increasing  the  peristal- 
sis in  the  small  intestine  to  such  a  degree  that  it  will  be 
moved  along  before  it  has  had  time  to  digest. 

Improper  or  Indigestible  Foods. — For  practical  purposes, 
the  digestibility  of  any  food  may  be  gauged  by  the  length 
of  time  which  it  remains  in  the  stomach,  since  the  stomach 
expels  the  food  as  soon  as  it  has  been  reduced  to  a  semi- 
fluid consistence.  Certain  articles  of  diet  so  react  on 
each  other  as  to  produce  an  insoluble  substance.  For 
example,  strong  tea,  taken  with  any  meat  meal,  converts 
the  albumin  of  the  meat  into  a  dense  precipitate  that  is 
absolutely  indigestible.  Glaret  and  coffee  both  delay 
digestion.  Again,  the  combination,  already  mentioned, 
of  vinegar  with  the  carbohydrates,  as  in  salads.  Cheese 
is  one  of  the  most  indigestible  of  substances.  All  fried 
foods  are  highly  indigestible,  because  the  fat  envelops 
the  food,  and  has  to  be  melted  off  before  the  gastric  juice 
can  act  on  the  substance  of  the  food  itself.  Pastry  is 
very  indigestible.  Of  the  vegetables,  beans,  while 
highly  nutritious,  are  exceedingly  difficult  of  digestion; 
also  boiled  cabbage,  cauliflower,  hot  breads,  iced  drinks, 
ice-cream,  and  water-ices. 

Food  May  be  taken  at  Too  Frequent  Intervals. — Digestion 
is  not  completed  until  the  last  particle  of  food  has  passed 
out  of  the  stomach  into  the  duodenum.  If  a  fresh  meal  is 
introduced  into  the  stomach  before  this  has  occurred,  the 
process  of  digestion  is  started  afresh  before  the  stomach 
has  had  time  for  the  rest  it  must  have  between  two  periods 
of  activity.  This  is  a  physiologic  law  which  is  habitually 
violated  in  the  prevailing  custom  of  afternoon  teas. 

Alcohol  is  a  direct  irritant  to  the  coats  of  the  stomach, 
and  its  use  forms  one  of  the  most  frequent  causes  of  gastric 


THE  DIGESTIVE   SYSTEM   AND   GOOD  DIGESTION     105 

diseases  of  the  present  day.  The  injurious  effects  of  alco- 
hol upon  the  stomach  are  that  it  acts  as  a  local  irritant, 
producing  dilatation  of  the  vessels  of  the  stomach  and 
subsequent  gastritis;  by  overstimulating  the  secretion  of 
hydrochloric  acid,  it  leads  to  hyperacidity  of  the  stomach; 
the  tartrates  and  malates  contained  in  wine  are  decom- 
posed in  the  stomach,  setting  free  organic  acids,  while 
the  acetic  acid  and  yeast  in  beer  set  up  an  acetic  acid  fer- 
mentation in  the  stomach-contents.  Alcoholic  drinks, 
when  taken  in  large  quantity,  eventually  produce  dilata- 
tion of  the  stomach. 

Alcohol  taken  into  the  stomach  along  with  the  food  has 
two  periods  of  action:  during  the  first  of  these  the  diges- 
tion of  albumin  is  impeded;  after  the  absorption  of  the 
alcohol  the  secretion  of  hydrochloric  acid  is  increased  to 
two  or  three  times  the  normal  amount;  even  after  stomach 
digestion  is  completed,  the  secretion  of  hydrochloric  acid 
continues  longer  than  it  normally  would. 

Tea. — In  addition  to  the  injurious  action  of  the  tannin 
of  the  tea  on  the  albuminous  constituents  of  food,  exces- 
sive tea-drinking  causes  digestive  disturbances  by  its 
action  on  the  nervous  system,  which  is  similar  to  that  of 
tobacco;  it  dilutes  the  contents  of  the  stomach  below  the 
point  of  concentration  at  which  digestion  can  efficiently 
take  place,  by  the  undoubted  tendency  that  constant  dis- 
tention of  the  stomach  with  hot  liquids  has  to  produce 
atony  of  the  stomach-walls.  Tea  is  most  injurious  to 
neurasthenic  persons. 

Both  tea  and  coffee  act  powerfully  to  retard  digestion. 
Coffee  acts  more  energetically,  as  it  is  generally  taken 
much  stronger.  It  is  certain  that  the  ordinary  use  of 
coffee  as  a  beverage  must  interfere  greatly  with  gastric 
digestion. 

Eating  when  in  a  state  of  nervous  exhaustion  or  great 
physical  fatigue,  prolonged  mental  strain,  or  excessive 
grief  may  be  sufficient  to  cause  severe  dyspepsia. 

The  Nature  of  Indigestion. — From  the  excessive  mucus 
in  the  stomach,  as  in  chronic  gastritis,  the  food  will  be 


106  PERSONAL  HYGIENE   FOR  WOMEN 

coated  by  mucus  which  will  prevent  the  ready  access  of 
gastric  juice,  or  there  may  be  an  excess  of  hydrochloric 
acid  in  the  gastric  juice,  as  the  result  of  the  irritation  of 
the  secreting  glands  from  the  use  of  alcohol,  tobacco, 
condiments,  or  the  lack  of  mastication. 

Motor  insufficiency  of  the  stomach  or  atony  of  the  stom- 
ach-walls may  result  from  general  weakness,  or  have  been 
caused  by  local  irritation  in  some  of  the  ways  above  men- 
tioned. 

From  a  prolonged  stay  of  food  in  the  stomach  there 
results  a  decomposing  mass,  teeming  with  microorgan- 
isms; from  the  acrid  and  irritating  nature  of  this  results 
a  catarrh  of  the  intestines  and  a  practical  arrest  of  the 
digestive  processes. 

From  a  chronic  catarrh  of  the  intestine  or  colitis,  as  it 
is  called,  there  may  result  diminished  peristalsis,  which 
leads  to  constipation. 

On  the  other  hand,  when  the  peristalsis  is  increased,  the 
food  is  hurried  along  the  intestines,  with  the  inevitable 
result  that  the  absorption  of  water  is  interfered  with  and 
the  stools  become  loose. 

With  defective  peristalsis  and  constipation  there  is 
fecal  retention,  abnormal  fermentation,  an  accumulation 
of  gas,  with  certain  nervous  phenomena,  such  as  headache, 
irritability  of  temper,  melancholia,  a  feeHng  of  pins  and 
needles  in  the  hands  and  feet,  numbness  and  tingling  in  the 
extremities.  It  is  a  question  as  to  whether  these  symp- 
toms are  reflex  in  origin  or  are  due  to  the  absorption  of 
toxins. 

The  s3miptoms  of  indigestion  are  sensations  of  full- 
ness or  pressure  referred  to  the  region  of  the  stomach. 
Pain  may  come  on  entirely  independently  of  taking  food ; 
it  may  come  on  when  the  stomach  is  empty,  or  it  may  come 
on  at  the  height  of  digestion  or  following  it.  Pain  coming 
on  independently  of  the  taking  of  food  is  neuralgic  in 
character.  In  neurasthenia  pain  may  come  on  when  the 
stomach  is  empty  and  be  relieved  by  the  taking  of  food — 
this  is  evidently  the  cry  of  the  system  for  food ;  or  the  pain 


THE  DIGESTIVE  SYSTEM   AND   GOOD   DIGESTION     107 

may  be  due  to  the  hypersecretion  of  hydrochloric  acid. 
Pain  coming  on  when  the  food  has  reached  the  stomach 
shows  some  abnormally  sensitive  condition  of  the  mucous 
membrane.  Pain  at  the  height  of  digestion,  or  about 
three  hours  afterward,  is  almost  invariably  due  to  an 
excess  of  hydrochloric  acid.  Pain  coming  on  four  hours 
after  meals  is  due  to  the  fact  that  the  stomach  has  not 
emptied  itself;  abnormal  fermentation  takes  place,  with 
the  formation  of  acrid  organic  acids,  which  irritate  the 
mucous  membrane  or  cause  an  evolution  of  gas  which  dis- 
tends the  stomach. 

Eructations  of  gas  may  be  due  to  an  atonic  condition 
of  the  walls  of  the  stomach,  and  the  gas  which  would  nor- 
mally pass  into  the  duodenum  accumulates  and  distends 
the  stomach,  or  the  gas  may  be  due  to  the  fermentation 
of  food,  due  to  its  prolonged  stay  in  the  stomach. 

There  may  be  an  eructation  of  a  small  quantity  of  acrid 
fluid,  which  may  or  may  not  be  brought  up  into  the  mouth. 
This  liquid  may  give  rise  to  a  sensation  of  heat  and  con- 
striction of  the  throat,  called  pyrosis  or  heart-bum;  or 
the  eructation  may  be  neutral  or  alkaline — the  so-called 
waterbrash;  this  most  usually  occurs  in  the  morning  on  an 
empty  stomach.  There  may  be  a  furred  tongue,  with  loss 
of  appetite.  This  may  be  caused  by  a  poisoned  condition 
of  the  blood  circulating  through  the  stomach,  where  the 
blood  is  loaded  with  the  effete  products  of  metabolism. 

The  term  metahoUsm  includes  all  the  chemical  processes 
taking  place  in  the  body,  by  which  the  available  elements 
of  food  are  prepared  for  nutrition,  changed  for  incorpora- 
tion into  the  tissues  and  fluids,  used  up  for  the  purposes 
of  movement  or  vitality,  and,  finally,  altered  into  forms 
capable  of  excretion. 

Intestinal  Indigestion. — This  is  a  much  more  common 
form  of  functional  disturbance  than  gastric  indigestion. 
It  is  a  well-established  fact  that  the  greater  part  of  the 
digestive  work  is  done  in  the  duodenum,  by  the  hepatic 
and  pancreatic  fluids.  The  duodenum,  also  called  the 
second  stomach,  has  none  of  the  peculiar  characteristics 


108  PERSONAL  HYGIENE  FOR  WOMEN 

of  a  receptacle  which  receives  crude  substances  that  the 
stomach  has.  There  is  a  much  greater  sensitiveness  of 
the  intestinal  canal  than  of  the  stomach,  which  is  accounted 
for  by  the  fact  that  the  sympathetic  nervous  svstem  sur- 
rounds the  intestines. 

Symptoms  of  Intestinal  Indigestion. — The  tongue  is 
pale  and  flabby  and  indented  at  the  edges  by  the  teeth; 
it  may  be  heavily  coated  white,  or  yellow  in  case  of  bilious- 
ness. There  is  a  bitter,  coppery  taste  in  the  mouth,  due 
to  taurochohc  acid,  a  common  symptom  of  Hthemia,  or  to 
imperfection  oxidation  of  albumin,  fatigue,  headache, 
buzzing  in  the  ears,  disturbances  of  sight,  loss  of  memory, 
faintness  and  vertigo,  and  emaciation. 

The  lack  of  appetite  leads  to  habitual  underfeeding, 
the  digestive  organs  themselves  become  weakened,  and 
they  in  turn  are  not  able  to  properly  digest  the  food. 
Severe  and  protracted  indigestion  may  lead  to  as  profound 
emaciation  as  tuberculosis  itself. 

Biliousness  and  Bilious  Attacks. — During  the  period 
of  digestion  there  is  a  physiologic  congestion  of  the  liver; 
this  is  increased  by  the  ingestion  of  food  of  an  irritating 
nature,  which  is  apt  to  cause  fermentation  in  the  intes- 
tines. 

Biliousness  and  bilious  attacks  are  generally  evidences 
of  indiscretion  in  diet,  some  blockade  in  the  intestinal 
canal,  or  constipation.  But  there  may  also  be  acute 
attacks  of  congestion  of  the  liver,  caused  by  a  severe  chill- 
ing of  the  body.  In  cases  of  chronic  congestion  of  the 
Hver  there  is  usually  intestinal  uncleanUness,  constipa- 
tion, and  a  greater  or  less  degree  of  auto-infection. 

Symptoms. — There  may  be  a  slight  chill  or  chilliness, 
or  a  dryness  of  the  skin,  with  a  feeling  of  feverishness; 
pain  in  the  region  of  the  liver,  radiating  to  the  right 
shoulder,  nausea,  vomiting  of  mucus  and  bile,  bilious 
diarrhea,  jaundice;  the  whites  of  the  eyes  are  yellowish, 
the  tongue  is  heavily  coated  yellow,  and  the  urine  is  slight 
in  quantity  and  yellowish.  There  is  a  marked  degree  of 
vertigo  and  a  floating  of  black  spots  before  the  eyes. 


THE  DIGESTIVE   SYSTEM  AND   GOOD   DIGESTION     109 

The  nights  are  restless,  filled  with  dreams  or  night- 
mares; there  is  often  a  tendency  to  wake  up  at  the  same 
early  hour  every  morning.  On  rising,  there  is  a  thick, 
metallic  taste  in  the  mouth,  frontal  headache,  an  inapti- 
tude for  mental  work,  and  a  feeHng  of  despondency  and 
depression. 

There  may  be  a  cumulative  auto-infection  which  has 
been  going  on  for  years.  The  eyes  and  skin  are  jaun- 
diced with  black  rings  under  the  eyes;  the  skin  is  dry, 
pale,  and  muddy,  with  more  or  less  eruptions.  There 
may  be  a  scarlet  redness  of  the  nose  and  cheeks  and 
eczema.  The  hands  and  feet  are  cold.  The  pulse  is  fee- 
ble, and  the  patient  is  anemic  from  the  impoverishment 
of  the  blood.  The  individual  is  depressed,  irritable,  and 
languid. 

Treatment. — The  best  treatment  is  to  take  2  grains  of 
calomel  just  before  retiring.  If  this  causes  a  free  evacua- 
tion of  the  bowels'within  ten  hours,  nothing  more  is  neces- 
sary. If  not,  some  saline  laxative  must  be  taken.  After 
this,  the  first  thing  on  rising  in  the  morning,  one  teaspoon- 
ful  to  one  tablespoonful  of  the  effervescing  granules  of  the 
phosphate  of  soda  should  be  taken  in  a  glass  of  cold  water. 
This  acts  very  pleasantly  on  the  liver,  and  is,  at  the  same 
time,  a  mild  laxative.  The  dose  of  calomel  must  never  be 
repeated  under  one  month's  time.  The  alkaline  mineral 
waters  are  good,  especially  those  of  Contrexeville  and 
Vittel. 

Most  important  in  the  treatment  of  aU  these  cases  is  the 
daily  exercise  in  the  open  air,  and  at  least  one  hour's 
brisk  exercise  is  essential.  Cold  sponge  or  other  cold 
baths,  given  according  to  the  condition  of  the  patient,  as 
directed  in  the  chapter  on  Hydrotherapy,  and  a  proper 
ventilation  of  the  house  day  and  night. 

Ptomain  Poisoning. — This  usually  causes  an  acute 
attack  of  indigestion,  coming  on  within  a  few  hours  after 
the  ingestion  of  the  poisoned  food,  as  canned  lobster, 
chicken,  and  fish.  The  symptoms  are  usually  nausea  and 
vomiting;  severe  pain  in  the  stomach  and  intestines;  there 


110  PERSONAL  HYGIENE   FOR  WOMEN 

may  be  a  rise  of  temperature,  and  either  constipation  or 
diarrhea. 

Treatment. — It  is  essential  to  empty  the  stomach  as 
quickly  as  possible,  so  that  the  poison  may  not  be  absorbed 
by  the  entire  system,  and  for  this  purpose  free  vomiting 
must  be  produced.  This  may  be  accomplished  by  the 
tickhng  of  the  back  of  the  throat  by  the  finger,  or  by  taking 
from  4  to  1  pint  of  lukewarm  water  with  a  little  table  salt 
in  it.  After  the  stomach  has  been  emptied,  one  glass  of 
veiy  hot  water,  containing  one  teaspoonful  of  the  bicar- 
bonate of  soda — baking  soda — should  be  taken  to  dis- 
solve the  mucus  and  to  wash  out  the  stomach. 

In  a  couple  of  hours  2  grains  of  calomel  should  be  given. 
If  this  does  not  act  freely  within  ten  hours,  it  must  be 
followed  by  a  seidlitz  powder  or  some  other  saline  laxa- 
tive. 

In  case  there  has  been  no  nausea  or  vomiting,  and  the 
first  indication  that  the  wom_an  has  ptomain  poisoning 
is  the  occurrence  of  rigors,  castor  oil  should  be  given,  as  it 
acts  more  quickly  than  calomel,  and,  in  addition  to  clear- 
ing out  the  bowel,  it  exerts  a  sedative  influence  upon  the 
irritated  intestine. 

The  Administration  of  Castor  Oil. — Take  an  ordinary 
medicine  bottle,  holding  from  6  to  8  ounces,  fill  it  half  full 
of  hot  milk,  add  one  tablespoonful  of  castor  oil,  insert  the 
cork,  and  shake  briskly  for  a  few  minutes.  At  the  end  of 
this  time  the  oil  will  have  disappeared,  having  formed 
a  perfect  emulsion  with  the  hot  milk.  Given  in  this  way, 
castor  oil  is  practically  tasteless. 

Diet  in  Indigestion. — When  there  is  an  acute  attack 
of  indigestion,  whether  it  is  gastric  or  intestinal,  there 
should  be  complete  abstinence  from  food  for  from  twelve 
to  eighteen  hours.  During  this  time  the  patient  should 
onlj^  take  occasional  sips  of  very  hot  water. 

After  the  symptoms  have  subsided,  liquids  may  be 
given  in  four-ounce  quantities  every  two  hours.  Hot 
milk  may  be  given,  to  which  may  be  added  15  grains  of 
baking  soda,  or  one  tablespoonful  of  lime-water,  or  one- 


THE  DIGESTIVE  SYSTEM   AXD   GOOD   DIGESTION     111 

third  part  Vichy,  or,  any  of  the  following  may  be  giA'en: 
chicken  broth,  barley  water,  the  white  of  egg  beaten  up 
with  plain  water,  beef-juice,  or  beef-tea. 

In  all  these  cases  the  first  thing  to  do  is  to  get  the 
mucous  membrane  of  the  stomach  and  intestine  in  a 
healthy  condition.  This  is  best  accomphshed  by  drinking 
a  glass  of  very  hot  water  three  times  a  day. 

Next  in  importance  comes  attention  to  the  diet.  Since 
the  digestive  organs  are  weakened,  only  such  foods  must 
be  taken  as  are  most  easily  digested. 

The  following  is  a  very  good  diet  in  this  class  of  cases  : 

Breakfast. — A  soft-boiled  egg,  or  an  egg  poached  on 
toast,  dry  toast,  and  a  glass  of  hot  milk.  If  the  milk 
disagrees  with  the  stomach,  it  may  be  diluted  with  one- 
third  part  Vichy.  If  there  is  a  tendency  to  constipation, 
a  baked  apple,  without  sugar,  may  be  added  to  this. 

Luncheon. — Raw  oysters  in  season,  cold  roast  lamb, 
beef  or  chicken,  bread,  and  a  very  little  butter,  apple- 
sauce, stewed  peare  or  peaches,  and  a  glass  of  hot  milk. 

In  changing  from  a  liquid  to  a  solid  diet  it  is  weU,  before 
giving  solids  en  masse,  to  give  beef  sandwiches  for  several 
days. 

The  sandwiches  are  made  as  foUows :  A  piece  of  tender, 
juicy  steak  is  scraped  with  a  blunt  knife  in  a  direction 
parallel  with  its  fibers.  In  this  way  the  pulp  is  freed  from 
the  fibers;  it  is  then  seasoned  with  a  little  salt  and  spread 
thinly  on  a  dry  piece  of  stale  bread.  This  makes  a  very 
delicate  and  palatable  sandwich. 

Dinner. — A  thin  soup,  beef,  lamb,  chicken,  or  broiled 
steak;  one  of  the  following  vegetables:  celerv%  raw  or 
stewed  with  white  sauce,  potatoes  baked  in  the  skin; 
asparagus  with  white  sauce ;  lettuce  with  a  French  dress- 
ing, made  with  lemon-juice;  cranberry  jelly.  There  must 
be  no  desert.  A  glass  of  water  may  be  sipped  slowlj^  after 
the  meal  is  over. 

When  the  digestion  improves,  a  cupful  of  weak  tea  may 
be  taken  for  breakfast  and  lunch. 

If  the  digestion   is  so  weak  that  very  little  can  be 


112  PERSONAL  HYGIENE   FOR  WOMEN 

taken  at  one  time,  a  cup  of  beef-tea,  chicken,  or  mutton 
broth,  with  a  plain  cracker,  should  be  taken  between 
meals.  A  glass  of  hot  milk  may  also  be  taken  before 
retiring. 

It  is  very  important  to  remove  all  fat  from  meat  broths. 
The  broth  is  allowed  to  become  cold,  and  the  fat  is  first 
skimmed  off  with  a  spoon;  after  this,  a  torn  piece  of  white 
blotting-paper  removes  all  the  small  particles  of  fat  which 
may  have  been  left. 

The  following  articles  of  diet  must  not  be  taken :  Rich 
soups  or  chowder,  veal,  pork,  hashes,  stews,  turkey, 
gravies,  fried  foods,  liver,  kidney,  pickled,  potted,  or 
smoked  meats,  or  fish;  goose,  duck,  sausage,  crabs,  lob- 
ster, salmon,  hot  breads,  pastries,  candies,  cheese,  ice- 
cream, nuts,  bananas,  ice-water,  malt,  or  spirituous 
liquors. 

Treatment  of  Acute  Diarrhea. — In  case  of  acute 
diarrhea  the  patient  should  remain  in  bed.  If  there  is 
severe  pain,  a  hot-water  bag  often  gives  relief.  The  diet 
should  consist  of  scalded,  not  boiled,  milk  and  dry  toast. 
A  glassful  of  hot  water  should  be  taken  three  or  four  times 
a  day. 

The  most  effective  procedure  in  these  cases  is  to  wash 
out  the  bowel  itself  with  hot  water,  which  contains  one 
teaspoonful  of  table-salt  to  the  pint  of  water;  this  removes 
the  mucus  and  is  an  astringent  to  the  inflamed  mucous 
membrane. 

For  the  medicinal  treatment  a  good  physician  should  be 
summoned  at  once,  as  the  cases  are  frequently  very  serious, 
and,  at  best,  may  nm  into  a  chronic  form  of  a  catarrhal 
inflammation  of  the  bowels.  The  longer  the  duration  of 
the  disease,  the  longer  does  it  take  to  accomplish  a  cure. 

Chronic  Intestinal  Catarrh. — There  may  be  consti- 
pation or  diarrhea,  or  the  two  may  alternate,  but  in  the 
chronic  forms  there  is  more  apt  to  be  constipation. 
Fecal  accumulations  may  sometimes  be  felt  by  placing 
the  hand  over  the  abdomen,  which  may  be  so  hard  that 
they  can  be  removed  neither  by  purgation  or  clysters. 


THE  DIGESTIVE  SYSTEM   AND   GOOD  DIGESTION     113 

If  the  catarrh  is  situated  in  the  lower  part  of  the  intestine 
or  in  the  rectum,  the  scybala  are  enveloped  in  mucus  or 
blood,  and  sometimes,  after  much  tenesmus  and  bearing 
down,  only  large  quantities  of  mucus  will  be  voided.  A 
frequent  result  of  this  condition  is  piles,  associated  with 
an  intense  itching  or  burning,  which  extends  up  into  the 
rectum. 

Constipation  and  Mental  Troubles. — A  noted  French 
writer  states  that  there  is  no  person  afflicted  with  mental 
troubles  who  is  not  a  sufferer  from  constipation,  at  least 
in  the  early  and  curable  stage  of  this  malady,  as  weU  as 
from  stomach,  liver,  and  intestinal  disturbances.  Even 
in  the  normal  individual  constipation  brings  about  torpor 
of  ideas,  inaptitude  for  work,  and  a  bad  temper,  while 
the  autointoxication,  which  is  caused  by  constipation,  is 
a  prolific  source  of  neurasthenia. 

It  must  be  remembered  that  the  intestine  is  a  permanent 
source  of  poisons,  which,  under  certain  conditions,  cause 
grave  alterations  in  the  principal  organs,  notably  in  the 
hver,  kidneys,  and  skin,  and  serious  functional  dis- 
turbances of  the  nervous  system. 

Normally,  the  organism  manages  to  protect  itself  against 
the  microorganisms  which  are  found  in  the  intestines; 
given,  however,  certain  conditions,  the  toxic  products 
can  be  generated  in  excess  of  the  powers  of  the  organism 
to  dispose  of  them,  such  as  errors  of  diet,  quantitative 
or  qualitative,  atony  of  the  muscular  walls  of  the  intestine, 
and,  above  all,  constipation.  The  higher  up  in  the  in- 
testine the  stasis  occurs,  the  more  serious  is  the  result. 
Constipation  is  considered  by  many  surgeons  as  the  most 
important  factor  in  the  production  of  appendicitis. 

There  is  frequently  a  condition  present  which  is  known 
as  semiconstipation,  and  which  is  most  deceptive  to  the 
patient.  There  may  be  a  bowel  movement  every  day, 
but  the  bowel  is  never  emptied ;  only  the  lower  portion  of 
the  hardened  fecal  matter  is  broken  off.  This  is  repeat- 
edly found  to  be  the  case  in  examining  women  for  some 
form  of  pelvic  trouble,  and  in  a  woman  who  says  that  she 

8 


114  PERSONAL   HYGIENE   FOR   WOMEN 

has  a  daily  evacuation  of  the  bowels,  and  has  had  one  that 
very  morning,  the  sigmoid  flexure  will  be  found  to  be 
packed  with  hardened  feces. 

Beside  the  clogging  up  of  the  digestive  system  by  the 
non-removal  of  the  waste-products  of  digestion,  the 
formation  of  hemorrhoids,  which  is  caused  by  the  mechani- 
cal pressure  on  the  veins,  and  so  interferes  with  their 
emptying  out  in  the  normal  way,  and  the  general  auto- 
intoxication of  the  entire  system,  there  are  also  caused  in 
women  serious  displacements  of  the  pelvic  organs,  to- 
gether with  their  congestion  and  inflammation. 

The  general  symptoms  of  autointoxication  are:  head- 
ache, vertigo,  palpitation  of  the  heart,  a  feeble  and  irreg- 
ular pulse,  irritabihty  of  temper,  melancholia,  numbness 
and  tingling  in  the  hands  and  feet,  and  the  emaciation  and 
loss  of  weight  are  sometimes  so  marked  as  to  lead  to  the 
suspicion  of  malignant  disease. 

Treatment  of  Constipation. — This  should  always  be 
preventive,  and  the  diet  is  a  most  important  factor.  The 
food  should  be  of  a  coarse  quality,  that  is,  such  as  directly 
stimulates  the  walls  of  the  intestine  to  contraction  by  their 
constituents,  or  by  the  large  amount  of  the  indigestible 
bulk.  Com  and  Graham  bread  should  be  substituted  for 
white  bread.  Toast  is  always  constipating.  Plenty  of 
fresh  fruit  and  vegetables  should  be  eaten.  For  those  who 
can  digest  them,  raw  apples,  eaten  just  before  retiring,  are 
a  great  aid.  The  drinking  of  a  sufficient  quantity  of 
water  daily  is  also  essential,  and  this  quantity  must  be 
3  pints.  A  glassful  of  cold  water,  taken  the  first  thing  in 
the  morning  on  rising,  is  often  very  effective.  If  this  is 
insufficient,  the  phosphate  of  soda,  as  already  directed, 
may  be  added. 

Habit. — Nowhere  is  the  effect  of  habit  more  conspicuous 
than  in  the  matter  of  a  daily  evacuation  of  the  bowels. 
There  should  be  a  fixed  time  every  day  for  this,  and  the 
very  best  time  is  in  the  morning,  directly  after  breakfast. 
Such  a  habit,  once  established,  will  enforce  itself  upon  the 
attention  and  make  regularity  a  necessity.     It  not  infre- 


THE  DIGESTIVE   SYSTEM   AND   GOOD  DIGESTION     115 

quently  happens  that  constipation  is  the  result  of  irregu- 
larity in  going  to  the  toilet.  The  school-girl  or  woman 
gets  up  a  little  late,  and,  although  she  may  feel  the  inclina- 
tion to  empty  the  bowels,  she  is  able  to  defer  it. 

If  the  movement  is  sufficiently  large,  one  stool  daily  is 
sufficient,  but  where  the  stool  is  sHght  in  quantity,  there 
may  be  two  or  three  during  the  day,  entirely  consistent 
with  health,  and  in  a  run  down  state  of  the  system  there 
are  apt  to  be  several  small  movements  rather  than  one  full 
stool.  So  long  as  the  stools  are  not  watery,  the  individual 
may  rest  assured  that  there  is  no  looseness  of  the  bowels. 

Constipation  should  never  be  allowed  to  become  chronic. 
It  is,  as  has  already  been  shown,  the  progenitor  of  myriads 
of  the  most  serious  diseases;  and,  after  the  bad  habits 
of  years  have  been  established,  it  is  one  of  the  most 
obstinate  of  diseases  to  cure.  In  every  case  a  good 
physician  should  be  consulted  at  once,  and  the  treatment 
should  be  persevered  in  until  the  cure  is  complete.  It  is  a 
weU-known  fact  that  all  medicines  for  this  trouble  lose 
their  effect,  the  dose  has  to  be  increased,  and  a  frequent 
change  made  from  one  laxative  to  another.  When  every- 
thing else  fails,  electricity  may  be  resorted  to.  It  is  one 
of  our  most  valuable  remedies,  since  it  brings  about  a  cure 
through  the  toning  up  of  the  muscular  walls  of  the  in- 
testine. 

The  constant  use  of  hot  clysters  to  empty  the  rectum 
is  one  of  the  most  pernicious  habits;  in  this  manner  the 
bowel  becomes  overdistended  and  loses  its  tone,  and  the 
fecal  mass  is  not  sufficiently  large  to  cause  the  distention 
of  the  rectum,  which  is  the  normal  stimulus  leading  to  the 
desire  to  defecate. 

The  Physiologic  Action  of  Moderate  Doses  of 
Alcohol. — The  result  of  a  series  of  experiments  by  Dr. 
Parke  were  as  follows :  "  By  quickening  the  action  of  the 
heart,  it  shortens  the  interval  of  rest,  and,  therefore,  in- 
terferes with  the  nutrition  of  the  heart.  It  also  produces 
palpitation  and  breathlessness.  Even  small  doses  of 
alcohol,  by  increasing  unnecessarily  the  action  of  the  heart, 


116  PERSONAL  HYGIENE  FOR  WOMEN 

are  injurious.  It  acts  on  the  nervous  system  by  lessening 
the  rapidity  and  the  deUcacy  of  the  impressions,  as  well  as 
by  lessening  the  power  of  control  of  a  train  of  thought. 
Further,  by  this  same  blunting  of  the  nervous  system, 
voluntary  muscular  power  is  impaired,  and  the  finer 
combined  movements  are  less  perfectly  made.  It  causes 
a  lowering  of  the  temperature  of  the  body,  and,  although 
it  is  taken  to  overcome  the  effects  of  exposure  to  cold,  it 
has  been  learned  that  persons  who  take  it  are  less  able  to 
resist  the  exposure  to  cold." 

As  the  result  of  modern  scientific  investigation  and  ex- 
perimentation, alcohol  with  its  compounds  has  been  taken 
out  of  the  list  of  beverages,  where  it  has  heretofore  been 
classified  with  tea  and  coffee,  and  out  of  the  list  of  foods, 
to  which  class  it  had  been  admitted  because  of  the  known 
oxidation  of  alcohol  in  the  body,  and  has  been  placed  in 
that  list  of  drugs  known  as  narcotics,  alongside  of  ether, 
chloroform,  opium,  and  cocain — all  of  them,  the  most 
deadly  drugs  in  the  Pharmacopeia,  yet,  when  used  by 
skilled  hands,  the  most  beneficent. 

The  first  effect  of  this  class  of  drugs  is  a  short  temporary 
stage  of  exhilaration,  more  or  less  rapidly  followed,  ac- 
cording to  the  amount  taken,  by  a  stage  of  sleepiness  or 
actual  insensibility,  which  lasts  longer  than  the  stage  of 
excitement,  and  this  in  turn  is  followed  by  a  long  period  of 
depression. 

Like  other  members  of  its  class,  alcohol  has  a  cumula- 
tive action,  the  residual  quantities  habitually  taken  ac- 
cumulate and  gradually  affect  the  efficiency  and  well- 
being  of  the  individual. 

A  point  that  must  always  be  borne  in  mind  in  giving 
any  medicine  is  that  not  a  few  drugs  have  a  curious  ten- 
dency to  induce  a  craving  for  their  repetition. 

The  amount  of  alcohol  contained  in  some  of  the  most 
commonly  used  of  the  alcoholic  beverages  is  as  follows: 
beer,  4  to  5  per  cent. ;  hard  cider,  from  5  to  10  per  cent. ; 
claret,  8  to  11  per  cent. ;  port,  9  to  22  per  cent. ;  champagne, 
10  to  15  per  cent. ;  rum,  gin,  and  strong  liquors,  40  to  50 


THE  DIGESTIVE  SYSTEM  AND   GOOD   DIGESTION     117 

per  cent.;  whisky,  44  to  50  per  cent.;  brandy,  48  to  56 
per  cent. 

These  alcoholic  beverages  are  often  made  still  more 
harmful  by  adulterations  by  ingredients  in  themselves 
harmful. 

A  large  percentage  of  alcohol  is  also  found  in  bitters 
and  patent  medicines. 

We  will  consider  the  subject  of  alcohol  under  the  fol- 
lowing aspects:  First,  the  question  of  alcohol  as  a  food; 
second,  the  effects  of  alcohol  on  the  digestive  system  and 
the  metabolism;  third,  the  effects  of  alcohol  on  the  heart 
and  the  muscular  system;  and  fourth,  the  effects  of  alcohol 
on  the  nervous  system. 

First,  Is  Alcohol  a  Food? — ^The  substances  used  as  foods 
act  in  providing  energy  for  muscular  work,  in  maintaining 
the  heat  of  the  body,  in  building  up  of  the  tissues,  and  in 
saving  the  waste  of  the  tissues.  Moreover,  a  food  which 
does  harm  to  any  organ,  or  to  the  system  as  a  whole, 
when  taken  in  moderate  repeated  quantities,  becomes  a 
poison  for  that  individual. 

A  food  may  be  defined  as  any  substance  which,  when 
absorbed  into  the  blood,  will  nourish,  repair  waste,  and 
furnish  force  and  heat  to  the  body,  without  causing 
injury  to  any  of  its  parts  or  loss  of  functional  activity. 
From  any  one  of  these  four  standpoints  alcohol  cannot  be 
regarded  as  a  food. 

The  physiologic  effects  of  alcohol  and  real  food-stuffs 
are  totally  different.  Fats,  carbohydrates,  and  nitroge- 
nous foods  after  mastication  at  once  begin  to  be  digested 
and  assimilated,  and  to  fulfil  the  true  functions  of  a  food 
by  maintaining  a  natural  temperature,  pulse-rate,  and 
tissue  repair  of  the  body,  without  any  disturbance  of  its 
mental  and  physical  functions  and  activities. 

Alcohol,  on  the  contrary,  is  absorbed  from  the  stomach 
unaltered  by  the  digestive  processes;  circulated  in  the 
blood  in  its  original  form,  it  at  once  interferes  with  the 
ordinary  activity  of  the  brain  and  other  organs,  and, 
by  its  anesthetic  action,  hampers  the  mental  and  phys- 


118  PERSONAL  HYGIENE   FOR  WOMEN 

ical  activities  and  interferes  with  the  processes  of  meta- 
bohsm. 

The  Effects  of  Alcohol  on  the  Digestive  System  and 
Metabolism. — The  local  action  of  alcoholic  liquids  is 
particularly  destructive  on  an  empty  stomach;  and  when 
taken  in  strong  solution,  but  it  is  also  known  that  smaller 
doses,  taken  continuously,  are  liable  to  effect  the  digestive 
organs  in  a  slower  though  similar  way. 

The  injurious  effects  of  alcohol  are  that  it  acts  as  a  local 
irritant,  producing  dilatation  of  the  blood-vessels  of  the 
stomach  and  subsequent  gastritis;  it  leads  to  hyperacidity, 
by  stimulating  the  secretion  of  hydrochloric  acid;  the 
tartrates  and  malates  contained  in  wine  are  decom- 
posed in  the  stomach,  setting  free  organic  acids,  and 
thus  producing  acidity;  the  acetic  acid  and  yeast  in 
beer  set  up  an  acetic  acid  fermentation  in  the  stomach- 
contents. 

Whether  taken  alone  or  with  food,  the  tendency  of  alco- 
hol throughout  is  to  lessen  the  churning  movements  of 
the  stomach,  and  leads  to  atony  of  that  organ,  which 
in  turn  leads  to  dilatation  of  the  stomach. 

Alcohol  appears  to  have  a  particularly  deleterious  effect 
on  the  digestion  of  women.  This  is  explained  by  the  fact 
that  men  lead  a  more  active  outdoor  life,  and  consequently 
retain  their  appetite  for  food  longer  than  women.  For 
the  same  reason,  they  are  able  to  work  off  the  effects  of 
drinking  more  easily  and  start  afresh  the  assimilation  of 
food.  The  indoor  life  led  by  women,  their  clothing, 
worn  tight  around  the  stomach,  are  added  causes  for 
lack  of  appetite.  Catarrh  of  the  stomach  results;  this  is 
followed  by  insufficient  food  and  an  increased  amount 
of  stimulants.  There  follow  nausea,  irregular  and  insuf- 
ficient nutrition,  indigestion,  and  a  faulty  elaboration  of 
the  food. 

By  its  action  on  the  liver  alcohol  interferes  with  the 
amount  and  quantity  of  bile,  and  so  inevitably  leads  to 
indigestion  and  constipation,  and  a  similar  interference 
with  the  action  of    the  liver-cells    and  their  chemical 


THE  DIGESTIVE  SYSTEM  AND   GOOD  DIGESTION     119 

changes  set  up  in  many  cases  gouty  conditions,  accom- 
panied by  mental  depression  and  irritability. 

Diseases  of  the  liver  occur  more  frequently  as  the  result 
of  taking  frequent  small  doses  of  alcohol,  though  never 
reaching  the  stage  of  intoxication,  than  as  the  result  of 
indulging  more  freely,  but  at  longer  intervals. 

The  Effect  of  Alcohol  on  the  Blood.- — The  blood  is  a  mix- 
ture of  corpuscles  and  a  fluid  known  as  the  blood  plasma. 
The  corpuscles  are  of  two  kinds — red  and  white.  The  red 
blood-corpuscles  are  the  oxygen  carriers;  they  carry  the 
oxygen  to  the  tissues,  where  they  readily  give  it  up.  They 
are  constantly  being  destroyed  by  the  liver  and  spleen, 
and  are  replaced  by  new  ones,  which  come  from  the  red 
marrow  of  bones.  The  white  corpuscles  are  much  fewer 
in  number,  but  they  play  a  most  important  part  in  pro- 
tecting the  body  against  disease.  It  is  now  about  twenty 
years  since  Professor  Metchnikoff,  of  the  Pasteur  Institute 
of  Paris,  announced  to  the  world  his  discovery  that  the 
white  corpuscles  have  the  power  of  destroying  the  mi- 
crobes to  which  so  many  diseases  are  due.  These  white 
blood-cells  form  the  standing  army  or  policemen  of  the 
body,  and  their  duty  is  to  attack,  and,  if  possible,  to 
destroy,  any  foreign  matter,  such  as  dust  or  disease 
germs. 

The  plasma  of  the  blood  contains  various  kinds  of  salts, 
and  include  sodium  chlorid  or  common  salt,  the  phos- 
phates, and  chlorids  of  calcium  and  potassium. 

The  way  which  the  body  fights  disease  is  partly  by  means 
of  the  white  blood-corpuscles,  which  totally  destroy  the 
germs,  and  partly  by  the  increase  in  the  blood  of  those 
chemical  substances  which  are  antidotes  for  the  poisons 
given  out  by  the  germs. 

Alcohol  taken  into  the  stomach  is  quickly  absorbed  and 
reaches  the  blood  in  two  minutes.  The  maximum  of 
alcohol  is  found  in  the  blood  in  fifteen  minutes  after  it  is 
swallowed. 

The  blood  is  the  medium  by  which  food  and  oxygen  are 
conveyed  to  the  tissues,  and  by  which  the  refuse  material 


120  PERSONAL  HYGIENE   FOR  WOMEN 

from  the  tissues  is  carried  away;  alcohol  interferes  with 

both  these  processes. 

The  red  cells  are  liable  to  become  damaged  and  anemia 
results.  It  has  now  been  proved  that  even  tiny  doses  of 
alcohol  paralyze  more  or  less  the  white  cells,  and  thus  in- 
terfere with  their  power  of  destrojdng  microbes.  Chemi- 
cal substances  tend  to  exert  a  delaying  or  inhibitory  in- 
fluence over  the  chemical  processes  of  the  body.  These 
chemical  processes  are  oxidation,  the  storing  up  of  nutri- 
ment, the  manufacture  of  secretion,  the  production  of 
energy  and  muscular  movement,  and  the  excretion  of 
waste  materials. 

The  greatest  possible  difference  exists  as  to  the  rate  at 
which  oxidation  goes  on.  ^Mien  there  is  nothing  to  hinder 
its  occurrence,  the  poisonous  toxins  and  waste  matters 
are  rapidly  burned  up  and  ehminated  and  health  prevails. 
Alcohol,  by  its  affinity  for  oxygen,  robs  the  tissues  of 
oxygen  which  they  would  otherwise  use  for  combustion. 
Hence  the  tissues  are  kept  starving  for  oxygen,  metabo- 
lism is  interfered  with,  and  they  cannot  get  rid  of  their 
waste  material. 

This  delayed  oxidation  tends  to  increase  the  body 
weight.  The  cells  in  an  intermediate  stage  of  fatty  degen- 
eration clog  the  body,  and,  of  course,  add  to  its  weight. 
The  natural  effect  of  taking  alcohol  is  to  make  the  body 
obese.  On  abstaining  from  alcohol,  the  superfluous 
tissue  is  often  burned  away,  and  the  weight  of  the  body 
reduced,  and  a  look  and  feeHng  of  youth  is  recovered. 

The  Effect  of  Alcohol  on  the  Heart  and  Circulation. — By 
the  circulation  we  understand  the  driving  of  the  fluid 
blood  around  the  body,  through  the  blood-vessels,  such 
driving  being  maintained  by  the  pumping  power  of  the 
heart,  which  is  practically  a  hollow  muscle. 

In  consequence  of  this  pumping  power  of  the  heart,  the 
blood  in  the  vessels  is  under  considerable  pressure,  which 
is  naturally  increased  if  the  blood-vessels  are  narrowed 
or  contracted,  and  diminished  if  the  blood-vessels  are 
expanded  or  dilated. 


THE  DIGESTIVE   SYSTEM   AND   GOOD   DIGESTION     121 

Gradual  deterioration  in  the  heart  power  is  a  cause  of 
premature  death.  One  of  the  early  indications  that  the 
foregoing  changes  may  be  occurring  in  a  heart  is  a  sense 
of  fatigue  and  breathlessness  on  slight  exertion,  or  a 
feeling  of  disinclination  for  normal  effort.  The  result  of 
such  depression  of  the  ef&ciency  of  the  heart  is  often  seen 
when  the  individual  is  attacked  by  some  disease;  she 
succumbs  to  heart  failure,  instead  of  being  able  to  resist 
the  disease.  This  probably  accounts  for  a  great  many 
deaths  between  forty  and  sixty  years  of  age. 

Further,  it  must  be  remembered  that  all  the  nutritive 
action  of  the  blood  depends  on  its  power  of  rapidly 
filtering  through  the  walls  of  the  blood-vessels  to  the 
tissues,  and,  conversely,  its  power  of  drawing  off  the 
waste-products  of  the  tissues  depends  on  the  facility  with 
which  such  products  can  penetrate  its  walls. 

As  soon  as  degeneracy  sets  in,  the  walls  of  all  vessels 
tend  to  become  thickened,  and  the  active  transference 
through  them,  more  and  more  prevented;  the  nutrition 
of  the  body  is  thus  gravely  hampered,  and,  with  the 
advance  of  this  thickening  of  the  walls,  the  vessels  are  less 
able  to  adjust  themselves  to  the  variations  in  pressure 
from  within;  and,  finally,  when  xmable  to  withstand  the 
pressure,  they  rupture,  causing  hemorrhage  and  apoplex;^', 
which,  when  occurring  in  the  brain,  cause  paralysis  and 
mental  decay. 

A  similar  degeneration  takes  place  in  old  age,  but  the 
point  is,  that  many  persons,  instead  of  waiting  until  old 
age  comes  to  them,  dehberately  precipitate  these  senile 
changes. 

The  Effect  of  Alcohol  on  the  Kidneys. — The  elaborate 
mechanism  of  the  kidneys  consist  of  a  filtering  system  of 
thousands  of  tubules,  arranged  closely  side  by  side,  whose 
function  it  is  to  carry  away  from  the  body  the  waste 
material,  which  otherwise  would  interfere  with  the  vitaHty 
of  the  different  organs. 

The  part  played  by  the  kidneys  in  rapidly  eliminating 
effete   material    cannot   be   too    carefully    safeguarded. 


122  PERSONAL  HYGIENE   FOR   WOMEN 

Anything  which  interferes  with  its  work  will  sooner  or 
later  cause  a  retention  of  waste-products  in  the  system, 
and  will  also  permit  of  the  escape  of  valuable  albuminous 
materials  of  the  substance  of  the  blood  through  the  filter- 
ing apparatus.  The  effect  of  alcohol  upon  the  kidneys 
can  only  be  described  as  disastrous.  In  proportion 
as  the  kidney  shrinks,  there  is  a  diminution  of  the  excre- 
tion of  urine,  and,  finally,  the  condition  known  as  Bright's 
disease  is  established. 

The  Effect  of  Alcohol  on  the  Muscular  System. — The 
muscular  tissue  forms  43  per  cent,  of  the  body  weight. 
It  has  been  proved  that  under  the  moderate  use  of  alcohol 
the  muscles  become  flabby  and  less  vigorous  and  effective ; 
that  troops  cannot  work  or  march  on  alcohol;  that  in 
training  for  athletics,  for  races,  or  for  other  sports,  total 
abstinence  is  always  practised;  the  true  sportsman  de- 
pends quite  as  much  on  his  brain  as  on  his  muscles  for 
success.  In  England  it  is  recognized  that  total  abstinence 
is  a  necessity  where  great  exertions  are  concerned,  and  it 
is  now  beyond  all  question  that  alcohol,  in  even  so-called 
dietetic  quantities,  diminishes  the  output  of  muscular 
work,  both  in  quantity  and  quality,  and  that  the  best 
physical  results  are  obtained  under  total  abstinence  from 
its  use. 

Alcohol  actually  lowers  the  temperature  of  the  body 
from  three-fourths  of  one  degree  to  three  degrees.  This 
depression  of  temperature  is  not  transient,  but  lasts  for 
several  days,  so  that  its  use,  when  the  person  is  exposed 
to  intense  cold,  is  extremely  hazardous  to  Hfe. 

The  Effects  of  Alcohol  on  the  Nervous  System. — Kraepelin 
has  carried  out  a  series  of  experiments  to  prove  the  effects 
of  small  doses  of  alcohol  on  the  output  of  work.  In  all 
mental  work  there  are  two  elements  to  be  considered, 
namely,  quality  and  speed.  Now,  all  observers  are 
agreed  that  the  quality  of  mental  work  is  affected  even 
before  speed,  more  mistakes  being  made.  Tests  were 
made  in  reading  aloud;  in  adding  figures  in  various  com- 
binations;  in   type-setting;  and   in  memorizing;  in   aU 


THE  DIGESTIVE   SYSTEM  AND   GOOD  DIGESTION     123 

these  instances  it  was  found  that,  after  taking  moderate 
doses  of  alcohol  for  a  number  of  consecutive  days,  the 
work  done  was  less,  was  less  accurate,  and  that  there 
was  a  decrease  in  the  power  of  memorizing. 

Another  series  of  investigations,  made  by  Rudin  to 
determine  how  long  the  intellectual  abilities  continue  to 
be  depressed  after  the  effects  of  alcohol  pass  off,  showed 
that  the  effects  of  a  single  dose  of  alcohol  persisted  until 
noon  or  evening  of  the  next  day. 

Von  Helmholtz,  one  of  the  greatest  observers  and 
thinkers  of  the  nineteenth  century,  noted  on  himself  the 
effect  of  alcohol  in  interfering  with  the  highest  powers 
of  thought  and  conception.  Describing  the  conditions 
under  which  his  highest  scientific  thoughts  had  matured 
and  come  to  fruition,  he  said:  "As  far  as  my  experience 
is  concerned,  they  never  come  to  a  wearied  brain  or  at  the 
writing-desk;  they  were  especially  inclined  to  appear  to 
me  while  indulging  in  a  quiet  walk  in  the  sunshine  or 
over  the  forest-clad  mountains,  hut  the  smallest  quantity 
of  alcohol  seemed  to  drive  them  away." 

Professor  Sikovsky's  testimony  is  that  "alcohol  dimin- 
ishes the  rapidity  of  thought,  makes  the  imagination  and 
the  power  of  reflection  commonplace  and  deprived  of 
originality,  acts  upon  fine  and  complex  sensations  by 
transforming  them  into  coarse  and  elementary  ones, 
provokes  outbursts  of  evil  passions  and  dispositions,  and  in 
this  predisposes  men  to  strife  and  crime,  and  upsets 
habits  of  work  and  perseverance." 

Gelf-control  is  one  of  the  highest  functions  of  the  brain, 
and  the  racial  power  which  results  to  a  people  as  a  conse- 
quence of  the  individual  practice  of  self-control  cannot  be 
too  highly  estimated.  Therefore,  children  are  trained  as 
far  as  possible  to  control  their  emotions  and  actions. 
Alcohol  diminishes  and  breaks  down  this  power  of  ac- 
quired self-control,  undoing  the  work  of  parents  and 
educationalists.  Quite  small  doses  are  often  responsible 
for  reckless  and  self-pleasing  actions,  which  are  far 
reaching  in  their  results  in  loss  of  moral  tone  and  self- 


124  PERSONAL  HYGIENE   FOR  WOMEN 

respect.  The  ideals  of  duty  are  lost  sight  of,  and,  at  best, 
leave  the  individual  in  a  laissez-faire  attitude.  Among 
the  depressant  effects  of  alcohol  are  intellectual  lethargy 
and  a  sense  of  fatigue,  which,  combined  with  the  other 
factors,  lessen  the  capacity  for  genuine  enjoyment  and 
pleasure. 


CHAPTER  IV 

THE    RESPIRATORY    AND    CIRCULATORY    SYS- 
TEMS:  THE   KIDNEYS 

The  Mechanics  of  Circulation  and  Respiration;  the  Circulatory 
Apparatus;  the  Lungs;  Hygiene  of  the  Lungs  and  Its  Relation  to  the 
General  Health;  Relation  of  Respiration  to  Body  Heat;  the  Res- 
piratory Functions  of  the  Abdominal  Muscles;  tne  Importance  of 
Good  Chest  Development;  Proper  Relation  Between  the  Height, 
Weight,  and  Chest  Measurements;  Chemical  Properties  of  Air; 
Town  and  Country  Air;  Dust  and  Its  Relations  to  Disease;  Role 
Played  by  Bacteria;  Ventilation;  the  Injurious  Effects  of  Overheated 
Air;  the  Proper  Degree  of  Moisture  for  the  Air  of  the  House;  Ventila- 
tion of  Bed-rooms. 

Care  of  the  Nose,  Throat,  and  Ears;  Impediments  to  Respiration; 
Ventilation  of  the  Limgs  and  Breathing  Exercises;  Cure  of  Chronic 
Bronchitis  by  Deep  Breathing  Exercises;  Relation  of  Colds  to 
Pneiunonia  and  Tuberculosis,  and  Their  Prevention. 

The  Kidneys  and  Their  Fvmction;  the  Physiology  of  the  Female 
Pelvic  Organs. 

It  is  said  that  diseases  of  the  lungs  are  the  cause  of 
four-fifths  of  all  indispositions,  ill  health,  and  actual 
disease  among  civilized  people,  and  that,  between  the 
age  of  fifteen  and  twenty-five,  almost  one-half  of  the 
mortality  is  due  to  pulmonary  tuberculosis. 

This  almost  universal  weakness  of  the  lungs,  as  it  may 
be  styled,  is  a  product  of  modern  civiHzation,  and  is 
caused  by  our  unhygienic  mode  of  life.  Too  little  im- 
portance is  attached  to  physical  development,  and  well- 
developed  lungs  can  only  be  found  in  a  well-developed 
chest;  too  little  time  is  spent  in  outdoor  exercise;  and 
private  houses,  public  conveyances,  and  public  assembly 
rooms  are  not  properly  ventilated. 

Good  development  of  the  chest  and  lungs,  and  thorough 
and  systematic  ventilation  of  the  lungs,  are  essential  to  a 
strong  heart,  a  vigorous  circulation,  and  power  of  the 
tissues  to  resist  disease. 

125 


126 


PERSONAL  HYGIENE   FOR  WOMEN 


The  Mechanics  of  Circulation  and  Respiration. — 

In  order  to  understand  the  mechanics  of  circulation  and 
respiration,  it  is  necessarj^  to  appreciate  four  funda- 
mental facts — that  the  thorax  is  a  distensible,  air-tight 
cage;  that  it  contains  and  is  filled  by  the  heart,  limgs, 
and  great  blood-vessels ;  that  the  exchange  of  gases  in  the 
blood  takes  place  in  the  lungs;  and  that,  on  the  develop- 
ment of  the  chest  and  respiratory  muscles,  depend  the 
development  of  the  lungs  and  the  force  of  the  circulation. 


F hating  ribs 
Fig.  7. — The  bony  thorax,  anterior  \aew  (Ingals). 


The  Thorax. — The  chest  or  thorax  is  a  cone-shaped, 
distensible  cage,  formed  of  bones,  elastic  cartilage,  and 
muscles.  The  spinal  column  forms  the  fixed  part  of  this 
Hving  cage,  and  the  ribs  are  attached  to  this  in  such  a 
way  as  to  allow  of  their  being  raised  in  inspiration,  thus 
increasing  the  anteroposterior  and  the  lateral  diameters 
of  the  chest. 

The  thorax  is  converted  into  an  air-tight  cavity  by 


THE   RESPIRATORY   AND   CIRCULATORY   SYSTEMS      127 

means  of  muscles.  The  base  is  made  up  of  one  huge 
muscle,  the  diaphragm.  This  is  attached  at  its  border  to 
the  ribs  and  posteriorly  to  the  backbone.  It  is  the  dia- 
phragm which  separates  the  cavity  of  the  thorax  from  that 
of  the  abdomen.  When  the  diaphragm  is  relaxed,  it  has 
a  concavoconvex  form,  the  convexity  being  directed 
toward  the  chest,  and  the  heart  and  lungs  rest  directly 
on  it,  while  the  concave  surface  covers  or  rests  on  the 
liver. 

The  Circulatory  Apparatus. — This  consists  of  a  central 
force  and  suction-pump,  the  heart,  and  a  series  of  elastic 
tubes  that  grow  smaller  the  further  from  the  heart  they 
are  situated;  they  divide  and  subdivide,  like  the  branches 
of  a  tree.  The  smallest  arteries,  called  capillaries,  from 
their  hair-like  size,  are  so  minute  that  they  only  allow 
the  passage  of  a  single  corpuscle  at  a  time  and  their  walls 
are  transparent. 

The  heart  is  a  somewhat  cone-shaped  organ,  placed 
between  the  two  lungs ;  it  is  situated  more  or  less  obliquely 
in  the  chest,  immediately  back  of  the  breast-bone. 
Roughly  speaking,  the  base  of  the  heart  corresponds  to 
the  right  edge  of  the  sternum,  while  the  apex  lies  a  little 
below  and  to  the  right  of  the  left  nipple. 

The  heart  is  divided  into  a  right  and  left  side.  The 
left  side  forms  the  force  pump,  whose  motive  power  is 
supplied  by  the  contraction  of  its  own  muscle-fibers. 
The  bright  red  blood,  with  its  fresh  supply  of  oxygen — 
hence  its  color — flows  from  the  lungs  into  the  left  heart, 
which  then  contracts  automatically  and  forces  the  blood 
into  the  arteries  of  the  body. 

The  arteries  consist  of  a  series  of  elastic  tubings ;  hence, 
the  smaller  the  tubing,  the  greater  the  resistance  which 
has  to  be  overcome  by  the  force  of  the  heart's  beat,  so 
that  during  violent  exercise,  when  the  contraction  of  the 
muscles  causes  a  pressure  on  the  minute  arteries  and 
capillaries  situated  in  them,  the  more  forcible  must  be  the 
beat  of  the  heart  to  overcome  this  additional  resistance. 
Likewise,  when  the  surface  of  the    body  is    suddenly 


128 


PERSONAL   HYGIENE  FOR  WOMEN 


chilled,  as  by  a  plunge  into  cold  water,  all  the  vessels 
situated  here  contract,  and,  again,  more  work  is  thrown 
on  the  heart. 

The  three  chief  factors  in  the  mechanics  of  the  circula- 
tion are  the  force  and  frequency  of  the  heart's  beat,  the 
peripheral  resistance,  and  the  elasticity  of  the  arterial 
walls.  Any  disturbance  between  these  relations  brings 
about  abnormal  conditions. 


Right  common 

carotid  artery' 

Subclavian 

arteries 

Innominate 

artery 

Arch  of  aorta 
Right  lung 

Superior  vena 
cava 

Right  auricle 


Coronary 
artery 


Fig.  8. — Front  view  of  heart  and  lungs,  showing  relations  to  other 
thoracic  organs  (Ingals). 

The  average  frequency  of  the  heart's  beat,  or  the  pulse, 
is  72  times  a  minute.  It  is  increased  by  exercise;  it  is 
quicker  in  the  standing  than  in  the  sitting  posture.  It 
is  quickened  by  meals,  and,  on  the  whole,  it  is  quicker 
in  the  evening  than  in  the  early  morning  hours.  Inde- 
pendent of  muscular  exertion,  it  is  quickened  by  great 
altitudes.  It  is  said  to  be  quicker  in  summer  than  in 
winter.  Its  rate  is  profoundly  influenced  by  mental  con- 
ditions. 


THE  RESPIRATORY  AND  CIRCULATORY  SYSTEMS      129 

The  whole  of  the  blood  of  the  body  passes  through  the 
heart  in  32  beats — that  is,  in  less  than  half  a  minute. 
The  greatest  part  of  this  time  is  spent  in  the  capillaries, 
There  the  tissues  are  obtaining  their  fresh  supplies  of  food 
and  discharging  their  waste  matter  into  it. 

The  heart,  great  blood-vessels,  and  the  lungs  are  placed 
in  the  air-tight  cavity  of  the  thorax,  and  are  subjected  to 
the  pumping  action  of  the  respiratory  movements.  The 
inspiratory  muscles  elevate  the  ribs,  at  the  same  time  that 


Fig.  9. — Relation  of  heart  and  great  vessels  to  the  wall  of  the  thorax. 
The  collapsed  lungs  are  drawn  slightly  aside  (after  Heath). 


the  diaphragm,  by  its  contraction,  pushes  the  contents  of 
the  abdomen  downward.  The  cavity  of  the  chest,  so 
enlarged,  causes  the  pressure  around  the  heart  and  the 
great  blood-vessels  within  the  chest  to  be  less  than  that 
on  the  blood-vessels  outside  the  chest;  hence,  during  each 
inspiration  the  venous  blood  is  sucked  back  into  the  right 
side  of  the  heart. 

The  tissues  deprive  the  blood  of  its  oxygen,  so  that  which 
flows  back  to  the  heart  in  the  veins  is  blue.    The  right 

9 


130 


PERSONAL  HYGIENE   FOR  WOMEN 


heart  then  sends  this  blue  blood  to  the  lungs,  that  it  may- 
get  rid  of  its  carbonic  acid,  which  is  not  only  not  needed, 
but  is  actually  injurious  to  the  body,  and  to  receive  a  fresh 
supply  of  oxygen,  which  has  been  carried  into  the  lungs  in 
breathing. 

The  blood  is  the  great  medium  of  exchange  between  all 
parts  of  the  body.  It  is,  at  the  same  time,  the  nourisher 
and  the  scavenger  of  all  the  tissues.  After  the  food  has 
been  liquefied  and  converted  into  new  substances  in  the 
digestive  system  it  is  poured  into  the  blood.  From  the 
blood  all  the  tissues  draw  material  to  renew  their  own 
worn-out  parts  and  other  material  which  they  store  up 


Fig.  10. — The  diaphragm  (after  IGtchen). 

as  latent  force,  which,  when  it  unites  with  the  oxygen  of 
the  blood,  becomes  active  force,  such  as  heat  and  motion. 

The  blood  holds  in  suspension  a  vast  number  of  minute 
cells  or  corpuscles ;  the  red  corpuscles  give  its  color  to  the 
blood,  and  are  the  oxygen  carriers,  while  the  white  are  the 
phagocytes  or  the  protective  agents  of  the  body  against 
disease. 

The  blood  constitutes  about  one-thirteenth  of  the  body 
weight.  Of  this,  one-fourth  is  distributed  to  the  heart, 
lungs,  and  great  blood-vessels,  one-fourth  to  the  liver,  one- 
fourth  to  the  skeletal  muscles^  and  the  remainder  to  other 
organs. 


THE   RESPIRATORY  AND   CIRCULATORY  SYSTEMS      131 

In  order  that  the  blood  may  be  a  satisfactory  medium 
of  exchange  between  all  the  tissues  of  the  body  two  things 
are  necessary — first,  there  must  be  through  all  parts  of 
the  body  a  flow  of  blood  of  a  certain  rapidity  and  general 
constancy;  and,  second,  this  flow  must  be  susceptible 
of  general  and  local  modifications. 

The  lungs  are  the  essential  organs  of  respiration  or 
ventilators  of  the  body.  They  are  two  in  number,  separ- 
ated from  each  other  by  the  heart,  are  placed  in  a  semi- 
distended  state  in  the  air-tight  thorax,  which  we  have 
seen  they,  together  with  the  heart  and  great  blood- 
vessels, completely  fill.  The  lungs  ultimately  consist  of 
air-cells,  surrounded  by  dense  plexuses  of  capillaries  and 
nerves.  The  air-cells  communicate  with  the  exterior 
through  the  bronchial  tubes,  trachea,  larynx,  throat,  and 
nose. 

The  larynx  is  the  organ  of  voice.  It  is  situated  be- 
tween the  trachea  and  the  base  of  the  tongue,  at  the  upper 
and  back  part  of  the  neck,  where  it  forms  a  considerable 
projection  in  the  middle  fine,  called  Adam's  apple. 

The  trachea  is  a  cyhndric  tube,  which  extends  from  the 
larjmx  downward  about  4^  inches,  when  it  divides  into  the 
right  and  left  bronchial  tubes.  The  bronchial  tubes,  on 
entering  the  lungs,  divide  and  subdivide,  until  finally  they 
terminate  in  a  lobule  which  is  composed  of  air-cells  and 
intercellular  passages. 

In  inspiration  the  cavity  of  the  thorax  is  enlarged  by 
an  active  contraction  of  the  muscles,  in  consequence  of 
which  the  pressure  of  air  within  the  lungs  becomes  less 
than  that  of  the  air  outside  of  the  body,  and  this  differ- 
ence of  pressure  causes  a  rush  of  air  through  the  trachea 
into  the  lungs,  until  an  equilibrium  of  pressure  is  estab- 
lished between  the  outside  air  and  that  within  the  lungs. 
This  constitutes  mspiration.  Upon  the  relaxation  of  the 
respiratory  muscles,  the  elasticity  of  the  chest-walls  and 
lungs,  aided  perhaps,  to  some  extent,  by  the  contraction 
of  certain  muscles,  causes  the  chest  to  return  to  its  original 
size.     In  consequence  of  this,  the  pressure  within  the 


132  PERSONAL  HYGIENE  FOR  WOMEN 

lungs  now  becomes  greater  than  that  outside,  and  the  air 
rushes  out  of  the  trachea,  until  the  equilibrium  is  once 
more  established — expiration. 

During  quiet  respiration  all  parts  of  the  lungs  are  not 
equally  expanded;  it  is  chiefly  the  apices  of  the  lungs, 
reaching  up  into  the  region  of  the  neck,  and  the  central 
parts  of  the  lungs,  which  undergo  the  least  change  of 
volume.  This  lack  of  a  thorough  distention  and  aeration 
of  every  part  of  the  lungs  is  a  cause  of  weakness  of  the 
lungs  as  well  as  of  the  entire  body,  for  it  is  precisely 
those  parts  of  the  lungs  which  are  the  least  active  that  are 
most  prone  to  become  the  seat  of  tuberculosis. 

In  forced  inspiration  the  cavity  of  the  thorax  is  in- 
creased from  2  to  3  inches,  partly  by  the  elevation  of  the 
ribs  and  partly  bj^  the  descent  of  the  diaphragm,  due  to 
the  contraction  of  its  muscular  fibers.  In  contracting, 
the  diaphragm  presses  upon  the  abdominal  viscera,  push- 
ing them  downward  about  3  inches,  so  that  a  projection 
of  the  flaccid  abdominal  walls  occurs.  The  movements  of 
the  diaphragm  are  less  extensive  in  women  than  in  men, 
which  is  believed  to  be  due  to  the  corsets  and  general 
manner  of  dress.  A  perfectly  free  mobility  is  necessary 
for  change  in  the  size  of  the  chest  and  lungs,  in  which  the 
respiratory  movements  take  place  from  sixteen  to  twenty 
times  a  minute. 

The  amount  of  air  entering  and  leaving  the  lungs  varies 
greatly  in  ordinaiy  and  forced  respiration,  being  often 
three  times  as  much  in  the  latter.  The  volume  of  air  is 
detennined  by  the  spirometer.  Mr.  Hutchinson,  who 
invented  the  spirometer,  has  defined  the  vital  ca- 
pacity of  the  lungs  as  that  amount  of  air  which  can  be 
expelled  by  the  most  forcible  expiration,  and  so  the  meas- 
ure of  the  individual's  respiratory^  power.  The  vital 
capacity  varies  according  to  a  number  of  conditions,  as 
age,  sex,  weight,  but,  most  important  of  all,  is  the  height. 
It  has  been  found  that  between  five  and  six  feet  the  vital 
capacity  increases  eight  cubic  inches  for  each  inch  in 
height. 


THE  RESPIRATORY  AND   CIRCULATORY   SYSTEMS      133 

The  vital  importance  of  the  role  which  oxygen  plays 
in  the  health  and  life  of  the  individual  may  be  better 
understood  from  the  facts  that  about  10,000  liters  of  air 
are  breathed  daily,  which  makes  the  amount  of  food  and 
drink  consumed  daily  seem  almost  infinitesimal,  and, 
important  as  the  quality  of  the  food  is,  the  quality  of  the 
air  is  much  more  so,  and,  finally,  that  one  can  live  for  some 
days  without  either  food  or  drink,  but  dies  in  a  few  min- 
utes if  the  supply  of  air  is  cut  off. 

Secretion  of  the  Lungs. — Like  the  lips  and  mouth,  the 
lungs  are  invested  on  their  free  inner  surface  by  a  delicate 
mucous  membrane,  which  constantly  secretes  a  clear 
viscous  fluid,  the  mucus.  The  lungs,  therefore,  like  the 
nose,  are  always  moist,  and  just  as  the  nose  is  cleared  by 
blowing  it,  so  the  lungs  are  cleared  by  hawking  or  cough- 
ing, A  sense  of  discomfort  or  a  feeling  of  irritation  of  the 
windpipe  induces  a  deep  inspiration,  followed  by  an 
explosive  expiration,  which  quickly  brings  up  the  mucus, 
so  that  it  can  be  expectorated.  The  only  difference  be- 
tween the  mucus  of  the  lungs  and  that  of  other  organs  is 
that  the  former  is  mixed  with  air  and  has,  therefore,  a 
frothy  appearance. 

The  secretion  of  the  lungs  naturally  flows  down  and 
accumulates,  until  it  is  voluntarily  brought  up  and  ex- 
pelled. Any  one  with  a  cold  on  the  chest,  or  who  is  sub- 
ject to  catarrh,  will  notice  that,  on  moving  about  in  the 
morning  in  making  the  toilet,  especially  on  raising  the 
arms  to  dress  the  hair,  expectoration  is  greatly  facili- 
tated, and  that  this  is  followed  by  a  feeling  of  clearing 
out  of  the  throat  and  lungs. 

Because  of  the  great  aid  given  to  the  lungs  in  clearing 
them  of  mucus,  moderate  exercise  in  the  open  air  is  a 
much  better  treatment  of  an  ordinary  cold  than  a  pro- 
longed stay  in  bed.  And  for  the  same  reason,  in  the  treat- 
ment of  lung  troubles,  so  soon  as  the  temperature  of  the 
patient  is  down  to  normal,  and  her  strength  makes  it  safe 
to  allow  her  to  move  about,  the  recovery  of  the  patient 
is  hastened  by  getting  up  and  moving  about  the  house. 


134  PEESONAL  HYGIENE   FOR  WOMEN 

Hygiene  of  the  Lungs  and  Its  Relation  to  the 
General  Health. — Two  conditions  are  essential  for  the 
preservation  of  the  health  and  prevention  of  diseases  of 
the  lungs — good  chest  and  lung  development,  and  a  con- 
tinuous supply  of  fresh  air  for  the  proper  ventilation  of 
the  lungs. 

Fully  one-third  of  the  whole  volume  of  blood  is 
always  circulating  in  the  lungs,  and  each  corpuscle  passes 
through  them  8000  times  in  the  twenty-four  hours.  In 
other  words,  the  lungs  are  the  vitualizing  stations  of  the 
corpuscles  which  unceasingly  go  hurrying  by.  If  these 
carbonic-acid-laden  corpuscles  arrive  in  the  lungs,  and  do 
not  find  the  requisite  amount  of  oxygen  awaiting  them, 
they  return  to  the  tissues,  carrying  part  of  their  carbonic 
acid  back  to  them  instead  of  a  fresh  supply  of  oxygen, 
and  so  the  tissues  are  weakened  instead  of  being  nourished, 
while  the  corpuscles  themselves  suffer  from  lack  of  proper 
nourishment  and  deteriorate  in  form  and  color.  Imper- 
fect ventilation  of  the  lungs  is  the  most  frequent  cause  of 
anemia  or  thinness  of  the  blood. 

It  must  not  be  overlooked  that  the  air  may  be  fresh  and 
pure,  and  yet  not  able  to  penetrate  aU  parts  of  the  lungs 
because  of  superficial  and  improper  breathing. 

Relation  of  Respiration  to  Body  Heat. — The  heat 
of  the  body  is  generated  by  the  oxidation  of  the  tissues. 
The  chilliness  experienced  by  persons  engaged  in  seden- 
tary occupations  is  by  no  means  always  caused  by  the 
low  temperature  of  the  room,  as  will  be  proved  by  the 
thermometer,  but  by  the  close  air  of  the  room  and  super- 
ficial respiration,  which  causes  internal  overheating  with 
imperfect  combustion.  The  correctness  of  this  state- 
ment may  be  proved  if  the  woman  wiU  throw  the  win- 
dows wide  open  and  take  deep  breathing  exercises  for  five 
minutes.  She  will  then  go  back  to  her  work  thoroughly 
comfortable.  In  other  words,  she  has  breathed  herself 
warm. 

The  Respiratory  Function  of  the  Abdominal  Mus- 
cles.— Well-developed  abdominal  muscles  play  an  im- 


THE  RESPIRATORY  AND   CIRCULATORY   SYSTEMS      135 

portant  part  in  expiration,  hence,  in  emptying  the  lungs 
of  their  impurities.  Under  normal  conditions  the  pres- 
sure in  the  abdominal  cavity  is  greater  than  that  of  the 
atmosphere;  hence  in  the  elastic  recoil  following  inspira- 
tion, the  abdominal  viscera  constitute  a  buffer,  so  to 
speak,  and  drive  the  diaphragm  upward. 

The  chief  causes  of  flabby  abdominal  muscles,  with  its 
consequent  low  intra-abdominal  pressure,  are  a  sedentary- 
life,  the  wearing  of  corsets  which  prevent  the  free  play  of 
the  abdominal  muscles,  and  the  overdistention  of  the 
abdominal  walls  by  repeated  pregnancies  and  by  the 
accumulations  of  fat. 

As  a  result  of  lax  abdominal  walls,  there  is  very  fre- 
quently an  enteroptosis  or  a  falhng  of  the  abdominal  con- 
tents far  below  their  normal  position;  this  includes  the 
liver,  spleen,  pancreas,  the  intestines  and  stomach,  and 
is  the  most  frequent  cause  of  floating  kidney. 

Further,  the  accelerating  influence  of  the  diaphrag- 
matic movements  on  the  circulation  is  seriously  interfered 
with. 

The  Importance  of  Good  Chest  Development. — 
The  least  chest  development  of  the  adult  woman— that 
is,  the  underarm  girth  around  the  chest — consistent  with 
good  health  is  28  inches,  and  this  girth  must  be  enlarged 
3  inches  on  forced  inspiration.  In  ordinary  respiration 
the  waist  expansion  should  be  from  ^  to  1  inch,  while  dur- 
ing muscular  activity  it  should  be  from  1 J  to  3  or  4  inches. 

In  women  the  movements  of  the  upper  part  of  the  chest 
are  very  conspicuous,  the  breast  rising  and  falling  with 
every  respiration;  whereas,  in  children  and  in  men  the 
movements  are  almost  wholly  confined  to  the  lower  part 
of  the  chest,  and  are  called  diaphragmatic,  in  contradis- 
tinction to  those  seen  in  women,  which  are  called  thoracic. 
It  is  now  the  opinion  of  many  observers  in  this  country 
and  in  Europe  that  the  habit  of  thoracic  breathing  in 
women  has  been  brought  about  by  constricting  the  waist 
and  the  lower  ribs.  Observations  made  among  the  In- 
dians and  Chinese  women  show  that  the  abdominal  is 


136  PERSONAL  HYGIENE   FOR  WOMEN 

there  the  type  of  breathing,  and  civilized  ■women  who 
wore  no  corset  had  relatively  good  abdominal  breathing. 
Further,  that  a  thoracic  type  of  breathing  can  be  pro- 
duced in  man  by  putting  him  in  a  corset. 

Vital  capacity  is,  as  we  have  seen,  the  term  employed 
to  denote  the  amount  of  air  that  can  be  expired  after  the 
fullest  possible  inspiration.  The  amount  for  persons 
5  feet  in  height  has  been  estimated  as  174  cubic  inches, 
with  an  increase  of  8  cubic  inches  for  every  inch  in  height 
above  this.  The  relation  between  height  and  vital  capac- 
ity is  rather  remarkable,  since  height  is  chiefly  determined 
by  the  length  of  the  legs,  and  not  by  the  size  of  the  trunk 
and  thorax.  This  is  due  to  the  fact  that  mobility  of  the 
chest  increases  with  stature. 

The  capacity  of  the  chest  is  determined  by  the  spirom- 
eter. A  person  who  can  only  blow,  say  from  180  to 
250  cubic  inches,  has  a  good  pair  of  lungs,  while,  on  the 
other  hand,  an  ability  to  blow  only  100,  even  where  per- 
cussion and  auscultation  had  revealed  nothing,  is  sus- 
picious. 

One  test  by  the  spirometer  is  not  sufficient  to  judge  of 
the  condition  of  the  lungs,  since  the  woman  may  be  ner- 
vous or  may  not  understand  how  to  breathe  into  it,  so 
that  a  number  of  tests  should  be  made  on  different  days, 
which  may  give  a  much  better  result,  though  no  change 
has  occurred  in  the  lungs. 

Proper  relation  between  the  height,  weight,  and  chest 
measurement : 


Height. 

Average  weight. 

Average  chest 

Feet.  Inches. 

Pounds. 

Inches. 

5 

120 

29.80 

5     1 

122 

30.60 

5    2 

125 

35.00 

5    3 

128 

35.75 

5     4 

131 

36.25 

5     5 

135 

37.00 

5     6 

139 

37.50 

5     7 

143 

38.00 

5     8 

147 

38.50 

5    9 

151 

39.00 

THE   RESPIRATORY  AND   CIRCULATORY   SYSTEMS      137 

The  Chemical  Properties  of  Air. — It  is  of  more  vital 
importance  that  the  air  which  we  breathe  should  be  pure 
than  the  food  which  we  eat  should  be,  although  the  latter 
is  universally  conceded  to  be  a  matter  of  prime  importance. 
The  reason  is  that  the  poisons  in  the  air,  inspired  by  the 
lungs,  pass  directly  into  the  blood,  whereas,  taken  into 
the  stomach,  the  action  is  much  slower,  and  there  is  at 
least  the  possibility  of  their  passing  through  the  digestive 
tract  unassimilated. 

The  olfactory  nerves  are  the  normal  guides  as  to  the 
purity  of  the  air,  and,  if  they  have  not  been  dulled  by 
long  usage  in  breathing  impure  air,  they  are  extremely 
sensitive  to  impurities  in  the  atmosphere. 

Country  Air. — In  the  open  air  there  is  a  con^ant,  even 
though  insensible,  movement  of  the  currents  of  air; 
the  result  is  a  constant  renewal  or  ventilation  of  the  air. 
There  is,  in  addition,  the  evaporation  from  brooks,  rivers, 
lakes,  the  dew  and  rain,  which  aid  in  cleansing  the  air 
from  dust ;  the  peculiar  freshness  of  the  air  in  the  country 
after  a  heavy  fall  of  rain  is  familiar  to  all. 

The  "  bouquet "  of  the  air,  most  noticeable  and  delightful 
in  the  early  morning,  especially  in  the  spring  of  the  year, 
is  due  to  the  fragrance  given  off  from  the  flowers,  plants, 
and  trees,  and  imparts  a  feeling  of  exhilaration  and  a 
sense  of  the  joy  of  living. 

Sunshine  increases  the  respiratory  movements. 

Wind  clears  the  air  of  impurities,  and  is  only  harmful 
when  it  carries  dust  with  it,  or  when  it  is  so  strong  that  it 
impedes  the  respiration  or  bodily  movements.  Very 
weak  persons  get  out  of  breath  easily  when  battling  against 
the  wind. 

Town  Air.— Even  the  outdoor  air  of  towns  has  its  full 
quota  of  oxygen,— 21  per  cent.,— and  so  is  healthier  than 
indoor  air.  The  carbonic  acid  in  the  air  varies  from  0.2 
to  0.6  per  cent.  Among  the  impurities  of  the  air  are 
smoke,  fog,  and  dust. 

Dust  and  Its  Relation  to  Disease. — Dust,  consisting 
of  particles  of  all  kinds  of  organic  and  inorganic  matter, 


138  PERSONAL  HYGIENE  FOR  WOMEN 

is  a  nuisance  of  indoor  as  well  as  outdoor  life.  That  the 
dust  in  cities  is  the  intolerable  nuisance  and  menace  to 
public  health  that  it  is,  is  due  to  the  filthy  condition  of 
the  streets. 

The  specific  cause  of  tuberculosis  is  the  tubercle  bacil- 
lus. Considering  the  prevalence  of  the  custom  of  spitting 
on  the  pavements,  streets,  floors  of  public  conveyances, 
and  public  haUs,  that  the  dust  from  the  streets  is  carried 
into  the  houses  on  the  shoes  and  the  trailing  skirts  of 
women,  it  is  seK-evident  that  anything  which  stirs  up  the 
dust,  as  sweeping,  stamping  on  the  floor  with  the  feet, 
dancing,  and  on  the  streets  strong  currents  of  air  and  high 
winds  are  a  most  serious  menace  to  the  health  and  lives 
of  the  communitj' . 

In  addition  to  the  fact  that  dust  is  the  great  carrier  of 
the  tubercle  bacillus,  the  particles  of  dust  cause  a  direct 
irritation  of  the  mucous  membranes  lining  the  nose,  throat, 
larynx,  and  bronchial  tubes. 

That  dust  is  an  important  factor  in  the  causation  of 
colds  may  be  inferred  from  the  facts  that  they  are  more 
common  in  the  city  than  in  the  country,  and  that  in  the 
city  they  are  more  frequent  in  the  spring  and  fall,  when 
the  streets  are  not  watered. 

The  R61e  Played  by  Bacteria. — Bacteria  are  distrib- 
uted nearly  evei-j^where  and  in  larger  quantities  than  is 
generally  believed.  The  air  in  open  spaces  in  cities  con- 
tains from  100  to  1000  bacteria  per  cubic  meter,  while  the 
air  of  an  inhabited  room  contains  from  6000  to  10,000. 

It  can  now  be  definitely  stated  that  microorganisms 
are  the  immediate  or  exciting  cause  of  bronchitis  observed 
in  diphtheria,  in  influenza,  measles,  whooping-cough, 
pneumonia,  etc.  These  microorganisms  are  conveyed 
both  directly  from  the  sick  to  the  well,  and  from  the  inhala- 
tions of  the  germs  floating  in  the  atmosphere.  \Mienever 
dust  is  raised,  we  breathe  in  a  great  number  of  micro- 
organisms. 

In  influenza  the  bacilli  are  found  in  the  secretions  of  the 
nose,  throat,  and  in  the  expectorations  from  the  lungs. 


THE  RESPIEATORT  AND   CIRCULATORY  SYSTEMS      139 

The  bacilli  are  not  only  the  cause  of  the  acute  infections, 
but  also  of  chronic  bronchitis. 

The  bacterial  flora  usuaUy  present  in  the  throat  and  the 
respiratory  passages  is  rich  and  varied.  So  long  as  the 
mucous  membrane  lining  these  passages  remains  in  a 
healthy  condition,  an  unfavorable  condition  is  offered  for 
their  growth  and  development  and  these  microorganisms 
are  harmless.  But  just  so  soon  as  the  general  vitality 
is  lowered,  or  there  is  an  impairment  of  the  normal  condi- 
tion of  the  epithelium  lining  the  respiratory  tract,  a  cul- 
ture-medium is  provided  in  which  these  germs  flourish 
and  grow.  Anything  which  will  cause  an  irritation  or 
congestion  of  the  mucous  membrane  of  the  throat  and 
bronchial  tubes  furnishes  the  necessary  conditions  for  the 
infection  to  take  place.  The  germs  themselves  excite  an 
acute  inflammation,  and  the  inflammation  extends  from 
the  head  or  throat  to  the  bronchial  tubes,  through  the 
spread  of  the  infective  agent  along  the  respiratory  tract. 

Ventilation. — Very  few  people  in  cities  spend  more 
than  one  hour  a  day  in  the  open  air,  which  means  that  they 
are  housed  up  for  the  other  twenty-three  hours,  so  that 
no  pains  should  be  spared  to  bring  up  the  quality  of  the 
indoor  air  to  approximate  as  nearly  as  possible  that  of 
the  outdoor  air.  The  air  of  houses  contains  many  more 
microbes  than  that  of  the  street. 

For  dwelling-houses  3000  cubic  feet  of  fresh  air  is  needed 
every  hour.  It  is  said  that  in  the  country  the  only  bad 
air  is  in  farmers'  houses,  whence  it  has  no  chance  to  escape. 

Direct  sunlight  kills  the  tubercle  bacillus  in  thin  layers 
of  sputum  in  five  or  six  hours,  and  diffused  sunlight  in 
several  days,  and  proper  ventilation  greatly  facilitates 
this  bactericidal  action.  A  large  cubic  space  is  of  little 
avail  if  the  ventilation  is  inadequate.  The  windows 
should  be  at  least  one-seventh  of  the  floor  space. 

The  air  of  the  house  must  be  fresh,  pure,  and  cool,  to 
allow  proper  ventilation  of  the  lungs  and  skin.  Colds 
are  prevalent  in  winter,  because  that  is  the  season  when 
people  are  housed  up  and  breathe  impure  air. 


140  PERSONAL  HYGIENE   FOR   WOMEN 

The  commonest  causes  of  impurities  of  the  air  in  houses 
are  the  expired  air  and  the  transudation  of  the  skin;  the 
production  of  the  combustion  of  lights  or  unconsumed 
gas  may  come  from  the  burner  when  lit,  if  the  pressure  is 
very  strong,  or  the  rubber  fittings  may  retain  the  gas; 
tobacco  smoke;  the  effluvia  of  simple  uncleanliness  of 
rooms  and  persons;  and  the  products  of  the  fluid  or  solid 
excreta  retained  in  the  room.  In  addition,  there  may  be 
special  conditions  which  allow  the  impure  air  to  flow  into 
the  room,  as  from  the  basement  or  cellar  of  a  house,  from 
imperfectly  trapped  soil  and  waste-pipes,  or  from  other 
impurities  outside  of  the  house. 

In  respiration  the  air  is  vitiated  by  a  decrease  in  the 
amount  of  oxygen  and  an  increase  in  the  amount  of  car- 
bonic acid ;  the  expired  air  contains  about  4  or  5  per  cent, 
less  oxygen  and  about  that  amount  more  of  carbonic  acid 
than  the  inspired  air.  It  has  been  estimated  that  an 
individual  takes  into  her  lungs  about  500  cubic  inches  of 
air  per  minute  and  exhales  the  same  amount  of  vitiated 
air.  The  expired  air  is  of  a  higher  temperature,  and  is 
loaded  with  aqueous  vapor.  The  organic  substances 
present  in  expired  air  are  in  part  the  causes  of  the  odor  of 
the  breath;  it  is  probable  that  many  of  them  are  of  a  poi- 
sonous nature.  The  air  is  still  further  vitiated  by  the 
products  of  decomposition  of  persons  having  decayed 
teeth,  nasal  catarrh,  and  disorders  of  the  digestive  systems, 
as  well  as  by  personal  emanations. 

When  the  sensibilities  of  the  sense  of  smeU  become 
dulled,  they  give  no  warning  of  the  sense  of  danger,  and 
the  individual  may  not  feel  conscious  of  the  harm,  al- 
though the  nervous  centers  may  be  greatly  depressed, 
and,  because  discomfort  has  not  been  experienced  in  a 
vitiated  atmosphere,  it  does  not  follow  that  harm  has 
not  been  done.  The  effects  are  slowly  and  imperceptibly 
cumulative,  but  are  on  this  account  none  the  less  injur- 
ious, and  are  now  recognized  as  being  among  the  most 
potent  and  wide-spread  of  all  the  predisposing  causes  of 
disease. 


THE  RESPIRATORY   AND   CIRCULATORY  SYSTEMS      141 

The  physiologic  effects  of  breathing  vitiated  air  are  that, 
owing  to  the  impurities  of  the  air,  the  respirations  become 
quicker  and  shallower,  the  heart's  action  more  rapid  and 
feeble;  there  is  a  more  or  less  irritation  of  the  mucous 
membranes  lining  the  nose,  throat,  and  larynx.  In 
extreme  cases,  where  many  people  are  crowded  together 
and  the  ventilation  is  totally  inadequate,  the  air  often 
becomes  so  impure  as  to  cause  headache,  lassitude,  nausea, 
and  fainting. 

The  long-continued  action  of  such  impurities  on  the 
olfactory  nerves  may  ultimately  induce,  through  the  cen- 
tral nervous  system,  alterations  in  the  respiration,  circula- 
tion, and  nutrition.  When  moderately  vitiated  air  is 
breathed  more  or  less  continuously,  the  individual  becomes 
pale  and  loses  her  appetite;  after  a  time  there  is  a  decline 
in  the  muscular  strength  and  animal  spirits.  The  aera- 
tion and  nutrition  of  the  blood  is  interfered  with,  and  the 
general  tone  of  the  system  falls  below  par. 

It  has  further  been  maintained  that  metabolism  is 
hindered  by  much-breathed  atmosphere.  In  addition  to 
the  ordinary  symptoms  of  discomfort,  the  long  occupancy 
of  so-called  stuffy  rooms  so  lowers  the  resistance  as  to  be 
conducive  to  the  contraction  of  colds  and  even  to  more 
serious  infections. 

People  in  this  lowered  condition  of  health,  which  is 
very  common  among  those  who  spend  the  greater  part  of 
the  day  indoors,  in  offices,  houses,  schools,  factories,  and 
workrooms,  offer  much  less  resistance  to  attacks  of  acute 
diseases  than  do  people  who  lead  an  outdoor  life. 

In  considering  the  ventilation  of  a  house,  the  purity  of 
the  air,  the  temperature,  and  the  dryness  of  the  air  must 
all  be  considered. 

The  test  now  generally  accepted  as  the  standard  of 
purity  of  the  air  is  not  the  chemical  one  of  the  estimation 
of  the  amount  of  carbonic  acid  contained  in  the  air  of  a 
closed  space,  but  that,  on  entering  a  room  or  closed  space 
from  the  outside  fresh  air,  no  sense  of  impurity  or  close- 
ness should  be  noticable. 


142  PERSONAL  HYGIENE   FOR  WOMEN 

The  so-calljd  natural  ventilation  of  houses,  which 
takes  place  through  the  porosity  of  the  walls,  the  cracks 
around  the  doors  and  windows,  is  generally  too  inconsider- 
able to  be  taken  into  account. 

Where  houses  are  heated  by  furnaces,  a  certain  amount 
of  ventilation  is  furnished  by  this  means,  but  the  air  is 
by  no  means  so  pure  as  the  air  of  a  house  heated  by  hot  air 
or  steam  pipes.  In  the  latter  case,  the  greatest  drawback 
is  the  drjmess  of  the  air. 

As  the  air  contained  in  an  inhabited  room  cannot  be 
kept  as  pure  as  the  outside  air,  the  object  of  ventilation  is, 
by  the  admission  of  the  pure  external  air,  so  to  minimize 
the  impurities  that  the  air  respired  may  not  be  detrimental 
to  health. 

The  most  effective  means  for  the  ventilation  of  houses 
and  apartments  is  the  throwing  wide  open  all  doors  and 
windows;  the  windows  must  be  opened  at  both  top  and 
bottom,  as  the  hot  impure  air  rises  and  the  cold  air  falls 
to  the  floor.  The  length  of  time  which  the  house  should 
be  left  open  will  depend  on  the  outside  temperature  and 
the  velocity  of  the  winds.  This  ventilation  of  the  entire 
house  should  be  carried  out  three  times  a  day — in  the 
early  morning,  at  noon,  and  again  in  the  evening. 

In  addition  to  this,  provision  should  be  made  for  a  con- 
stant access  of  fresh  air  to  the  room.  A  simple  and 
rather  primitive  method  is  by  raising  the  lower  sash  by 
a  strip  of  wood  several  inches  in  height  and  the  exact 
width  of  the  window.  The  air  will  then  enter  the  space 
between  the  upper  and  lower  sashes.  Some  such  or 
any  better  method  of  ventilation  should  be  in  continuous 
use,  day  and  night,  when  the  room  is  occupied.  So  soon 
as  the  weather  is  sufficiently  mild,  some  of  the  windows 
should  be  left  open  aU  the  time. 

When  the  air  of  a  room  is  fresh  and  pure,  the  human 
system  is  furnished  with  all  the  oxygen  it  can  consume, 
and  heat  is  thus  introduced  into  the  body,  so  that  a 
lower  external  temperature  is  necessary  for  comfort. 
Hence,  supplying  a  sufficient  quantity  of  fresh  air  mini- 


THE   RESPIRATORY   AND    CIRCULATORY  SYSTEMS      143 

mizes  the  amount  of  coal  consumed,  besides  increasing  the 
vigor  of  the  body. 

The  temperature  of  the  house  will  depend  on  the  occupa- 
tion, age,  and  health  of  the  inhabitants.  With  a  sedentary 
occupation,  a  temperature  of  from  64°  to  70°  F.  is  the 
most  suitable.  The  temperature  of  the  bedroom  at 
night  should  not  be  allowed  to  fall  below  50°  F.  Every 
room  in  the  house  should  be  furnished  with  a  thermometer. 

The  Injurious  Effects  of  Overheated  Air. — A  rise 
of  temperature  in  the  surrounding  air  diminishes  the 
amount  of  oxygen  consumed  and  the  amount  of  carbon 
dioxid  discharged ;  a  fall  of  temperature  has  the  opposite 
effect.  In  addition,  this  overheated  air  forms  a  hot 
jacket  about  the  body,  which  prevents  the  radiation  of 
heat  necessary  to  keep  the  body  in  a  healthy  condition. 

For  the  same  reason,  when  out-of-doors,  furs  should 
not  be  worn  close  up  around  the  neck,  and  fur  coats 
should  only  be  worn  in  the  extremely  cold  weather. 
Paper  and  rubber  worn  about  the  body  act  in  the  same 
way,  by  preventing  the  radiation  of  heat  and  moisture — 
practically  steam  jackets  are  formed;  the  skin  is  rendered 
very  sensitive  and  susceptible  of  chilling  on  the  shghtest 
fall  of  temperature. 

The  Proper  Degree  of  Moisture  of  the  Air  of  the 
House. — The  air  below  the  freezing-point  is  deprived 
of  much  of  its  moisture;  brought  into  the  house,  and 
raised  from  70°  to  80°  F.,  or  drawn  into  the  nostrils  and 
raised  to  98°  F.,  it  must  take  up  its  quota  of  moisture. 
This  moisture  must,  therefore,  be  provided  in  the  air  of 
the  house.  In  the  case  of  houses  heated  by  furnaces, 
some  moisture  is  furnished  by  the  water-pans  of  the 
furnace;  but  in  the  case  of  heating  by  hot  air  and  steam 
pipes,  there  is  less  circulation  of  air,  the  air  is  very  much 
drier,  and  generally  of  a  very  much  higher  temperature. 
A  satisfactory  method  of  furnishing  these  houses  with 
the  proper  degree  of  moisture  has  not  yet  been  invented. 

One  is  only  comfortable  in  a  dry  air  when  it  is  of  a  low 
temperature.     When  the  dry  air  becomes  heated,  there  ia 


144  PERSONAL  HYGIENE   FOR  WOMEN 

more  moisture  given  off  by  the  mucous  membranes, 
whicli  causes  a  feeling  of  dryness  and  irritation  in  the 
nose,  throat,  and  larynx;  there  may  also  be  a  sensation 
of  uneasiness  of  the  chest,  and,  at  the  same  time,  the 
individual  feels  chilly. 

Persons  constantly  breathing  abnormally  dry  air  lower 
the  resisting  power  of  the  respiratory  mucous  membranes 
and  become  very"  susceptible  of  taking  cold. 

Since  the  degree  of  moisture  of  the  air  of  a  house  is 
equally  important  as  its  temperature,  every'  room  should 
be  furnished  with  a  hygrometer,  which  should  register 
from  65  to  70  per  cent,  of  moisture. 

The  Ventilation  of  Bed-rooms. — The  importance 
of  the  proper  ventilation  of  the  sleeping-room  will  be 
seen  from  the  fact  that  two-thirds  of  the  oxygen  absorbed 
in  the  twenty-four  hours  is  absorbed  between  6  o'clock 
in  the  evening  and  6  o'clock  in  the  morning;  and  on 
the  state  of  the  air  of  the  bed-room  will  depend  greatly 
the  vitality  of  the  individual.  During  sleep  inspiration 
occupies  ten-twelfths  of  the  respiratory  period,  while  at 
other  times  it  occupies  only  five-twelfths  of  that  period. 
In  a  closed  room  the  oxygen  would  eventually  be  con- 
sumed, the  air  become  filled  with  impurities,  and  the  body 
languish  for  want  of  oxygen  and  incapacity  to  throw  off 
its  impurities. 

The  air  of  the  room  should  be  perfectly  fresh  on  retiring; 
where  it  has  been  used  as  a  sitting-room,  it  should  be 
throT^Ti  wide  open  and  thoroughly  ventilated  just  before 
going  to  bed.  The  temperature  of  the  room  should  not 
be  above  65°  F.  In  the  bed-room  at  night  all  the  air 
coming  into  the  room  should  come  from  the  same  side 
of  the  room,  and  the  doors  opposite  should  be  closed. 
If  the  room  is  small,  and  the  window  is  at  the  head  or 
foot  of  the  bed,  some  provision  must  be  made  to  screen  the 
bed,  and  to  allow  the  air  to  enter  the  room  without 
falling  directly  on  the  sleeper. 

In  the  intense  heat  of  summer,  especially  if  the  air  is 
saturated  with  moisture,   one  sleeps  much  more  com- 


THE  RESPIRATORY   AND   CIRCULATORY  SYSTEMS      145 

fortably  on  the  side,  with  the  face  almost  at  the  edge  of 
the  bed;  in  this  way  the  formation  of  a  stagnant  pool 
of  exhaled  air  about  the  face  is  prevented,  which  would 
otherwise  be  rebreathed,  and  greatly  increase  the  feeling 
of  discomfort  and  malaise. 

On  retiring  at  night  the  clothes  worn  during  the  day 
should  be  spread  out  over  chairs  to  become  thoroughly 
ventilated,  instead  of  being  hung  up  in  a  closed  press  or 
closet.  From  a  sanitary  point  of  view,  it  is  essential 
that  every  article  of  clothing  worn  during  the  day  should 
be  removed  at  night.  Both  clothes  and  body  need  venti- 
lation. 

In  the  morning  the  clothes  should  all  be  taken  off  the 
bed,  and  they,  as  well  as  the  night-clothes,  should  be 
spread  out  to  be  aired  during  the  ventilation  of  the  room. 
The  windows  are  thrown  wide  open  when  one  goes  to 
breakfast. 

The  Care  of  the  Nose,  Throat,  and  Ears. — It  will  be 
most  profitable  to  consider  the  care  of  the  nose,  throat, 
and  ears  together,  since  the  mucous  membrane  lining 
these  cavities  is  continuous,  and  so  there  is  always  great 
danger  of  an  inflammation  of  one  extending  to  the  others. 

It  has  been  calculated  that  about  one-third  of  our  adult 
population  are  notably  deaf  in  one  or  both  ears.  In  the 
majority  of  cases  deafness  is  the  result  of  colds  and 
throat  troubles,  and  much  can  be  done  to  prevent  its 
occurrence. 

The  nose  communicates  through  the  nasal  fossae  with 
the  nasopharynx,  and  the  mucous  membrane  hning  the 
nose  is  continuous  with  that  Hning  the  throat. 

The  nose  performs  four  important  functions — it  serves 
as  a  passageway  for  the  air  in  breathing,  and  it  warms, 
moistens,  and  filters  the  inspired  air;  it  is  the  organ  of 
smell;  it  aids  in  phonation;  and  it  affords  ventilation 
to  the  ears  and  accessory  sinuses.  But  by  far  its  most 
important  function  is  the  role  which  the  nose  plays  in 
respiration.  To  supply  the  large  amount  of  water  neces- 
sary to  moisten  the  inspired  air,  it  has  been  calculated 
10 


146  PERSONAL  HYGIENE  FOR  WOMEN 

that  about  one  pint  of  water  must  be  secreted  by  the 
nose  daily;  part  of  this  amount  of  moisture  is  furnished 
by  the  tears.  Mouth-breathing  always  causes  dryness 
of  the  throat. 

The  filtration  of  the  air  is  accomplished  first  through 
the  action  of  the  hairs  at  the  external  margin  of  the  nose, 
which  hinder  the  entrance  of  large  particles,  and,  second, 
by  the  adherence  of  small  particles  to  the  moist  surface 
of  the  intricate  passages  of  the  nose  and  nasophar3Tix. 
The  microbes  are  expelled  with  the  dust;  in  addition  to 
this,  the  nose  probably  has  the  power  of  destroying  any 
bacteria  through  the  action  of  its  germicidal  mucus. 

Obstruction  of  the  Nasal  Passages. — In  adults  the  com- 
monest modes  of  obstruction  are  the  bending  of  the  nasal 
septum  to  one  side,  or  by  a  thickening  of  the  septum 
by  which  one  nostril  may  be  completely  closed  up.  The 
occlusion  may  also  be  due  to  the  swelling  of  the  mucous 
membrane  or  the  presence  of  polypi. 

In  children  the  most  common  form  of  obstruction  of 
the  nose  is  by  the  adenoids  and  the  enlargement  of  the 
tonsils;  this  enlargement  may  be  so  great  as  to  prevent 
nasal  breathing  and  interfere  with  the  normal  ventilation 
of  the  ears. 

The  Throat  or  Pharynx. — The  throat  or  pharynx  is  the 
upper  and  funnel-like  portion  of  the  alimentary  canal, 
which  is  seen  at  the  back  part  of  the  mouth.  It  extends 
up  back  of  the  nose.  The  cavity  of  the  throat  is  some- 
what separated  from  that  of  the  mouth  by  the  soft  palate. 
This  is  a  membranous  curtain,  which  is  attached  to  the 
posterior  part  of  the  hard  palate.  The  pendulous  part 
of  the  soft  palate  is  known  as  the  uvula.  The  uvula 
sometimes  becomes  so  greatly  relaxed  that  it  rests  on  the 
base  of  the  tongue,  which  causes  a  constant  irritation 
and  slight  cough,  a  condition  which  is  easily  relieved  by 
a  few  astringent  applications. 

On  looking  into  a  mirror  there  will  be  seen,  on  either 
side  of  the  throat,  two  arches,  formed  by  folds  of  mucous 
membrane;   these  are  known  as  the  pillars  of  the  throat. 


THE   RESPIRATORY   AND   CIRCULATORY  SYSTEMS      147 

Between  these  pillars,  on  either  side,  is  an  almond-shaped 
body  called  the  tonsil.  In  health  the  tonsil  should  not 
protrude  beyond  the  anterior  pillar. 

Causes  of  Diseases  of  the  Nose  and  Throat. — Exposure 
to  wet  and  cold,  when  insufficiently  clad,  or,  even  worse, 
sitting  still  with  damp  skirts  or  shoes  on.  A  still  more 
potent  factor  than  exposure  to  cold  is  the  relative  degree 
of  humidity  of  the  atmosphere;  great  humidity  is  fre- 
quently accompanied  by  epidemics  of  influenza.  Ex- 
posure to  very  high  winds;  sudden  changes  of  tempera- 
ture; the  very  dry  air  and  the  overheating  of  houses; 
insufficient  covering  at  night;  the  inhalation  of  irritating 
vapors  and  finely  divided  mechanical  irritants.  Also, 
gastro-intestinal  affections  and  uric  acid. 

Chronic  enlargement  of  the  tonsils  predisposes  to 
tonsillitis  and  to  aU  the  infective  and  contagious  throat 
diseases.  In  addition,  the  breath  is  apt  to  be  fetid,  and 
swallowing  the  mucus,  germs,  and  toxins  has  a  deleterious 
effect  on  the  stomach  and  general  health.  Mouth-breath- 
ing and  anemia  often  follow,  and  there  is  an  increased 
liability  to  inflammation  of  the  eyes. 

The  Importance  of  a  Healthy  Condition  of  the  Throat 
and  Nose. — The  nose  and  throat  are  the  portals  of  entrance 
to  the  bronchial  tubes  and  lungs,  and  it  depends  on  the 
condition  of  their  mucous  membranes  whether  the  germs 
of  disease  wiU  find  lodgment  here  and  be  carried  down 
into  the  bronchial  tubes  and  lungs,  or  whether  they  will 
be  expelled  with  the  mucus. 

Any  irritant  which  destroys  the  vitality  of  the  epi- 
thelium covering  the  mucosa,  or  a  local  congestion  which 
interferes  with  the  nutrition,  circulation,  and  secretions 
of  the  part,  offers  favorable  conditions  for  the  culture  of 
bacteria  normally  present.  Also,  anything  which  will 
cause  a  lowering  of  the  general  health,  and  thereby 
lessen  tissue  resistance,  acts  as  a  predisposing  cause  to 
local  inflammation,  while  the  germs  themselves  excite 
inflammation  by  their  active  growth  in  loco. 

From  these  facts  will  also  be  seen  the  importance  of 


148  PERSONAL  HYGIENE   FOR  WOMEN 

having  cut  short,  as  rapidly  as  possible,  any  congestion  or 
inflammatory  troubles  of  the  nose  and  throat. 

Prevention  of  Nasal  Catarrh  and  Sore  Throat. — First  in 
importance  comes  attention  to  the  general  health.  Under 
this  must  be  considered  the  clothing,  food,  ventilation, 
and  exercise. 

The  clothing  should  be  Hght,  yet  sufficiently  warm  to 
be  a  protection  against  the  cold  and  winds.  Heavy  shoes 
with  thick  soles  are  necessary  to  protect  the  feet,  and  it 
is  not  so  much  the  matter  of  getting  wet  as  it  is  of  sitting 
down  with  damp  clothing  on. 

An  atmosphere  filled  with  dust  in  sweeping  should  not 
be  tolerated  in  any  well-kept  house. 

Local  Treatment  for  the  Prevention  and  Cure  of  Mild 
Cases  of  Nasal  Catarrh  and  Sore  Throat. — The  treatment 
is  practically  the  same.  The  toilet  of  the  nose  and  throat 
should  be  made  at  least  as  often,  and  at  the  same  time, 
as  that  of  the  teeth;  certainly,  the  first  thing  on  getting 
up  in  the  morning  and  again  before  dressing  for  dinner. 
In  our  seaboard  cities  and  towns,  at  least,  there  is  a  very 
general  predisposition  to  some  degree  of  congestion  of 
the  mucous  membrane  of  the  nose  and  throat.  This  means 
an  abnormal  amount  of  mucus  which  collects  in  the  parts 
during  sleep.  Again,  on  coming  in  from  out-of-doors 
on  a  windy  day  a  large  amount  of  dust,  which  means 
microbes  as  well,  has  become  lodged  in  the  mucous  mem- 
branes of  the  nose  and  throat. 

This  toilet  of  the  nose  and  throat  is  best  carried  out 
by  means  of  a  nasal  spray.  The  spray  apparatus  consists 
of  a  bottle  holding  some  two  ounces,  a  hard-rubber 
spray  piece,  and  a  bulb  with  tubing  to  force  the  fiquid 
through  the  spray  piece.  The  tip  of  the  spray  should 
have  the  form  of  a  cone;  this  should  be  introduced  into 
each  nostril,  the  bulb  squeezed  several  times,  until  the 
amount  of  fluid  is  sufficient  to  be  hawked  out,  and  this 
process  is  facilitated  by  holding  the  mouth  open  during 
the  sprajang  of  the  nostrils.  After  the  nostrils  have  been 
thoroughly  cleansed,  the  throat  should  be  sprayed  directly. 


THE  RESPIRATORY  AND  CIRCULATORY   SYSTEMS      149 

The  liquids  used  must  be  bland  and  unirritating,  and 
only  enough  should  be  used  at  one  time  to  cleanse  the 
parts.  There  are  on  the  market  excellent  alkahne  and 
antiseptic  tablets;  one  tablet  should  be  dissolved  in  a 
spray-bottle  not  quite  full  of  water.  This  solution  keeps  in 
perfect  condition,  and  is  always  ready  for  use. 

A  solution  of  boric  acid,  in  the  proportion  of  two  tea- 
spoonfuls  of  boric  acid  to  one  pint  of  water,  may  also  be 
used. 

If  the  nose  and  throat  are  inflamed,  this  so-called  water 
spray  should  be  followed  by  an  oil  spray,  which  will  be 
found  to  be  most  soothing  and  heahng.  A  separate 
apparatus  for  this  wiU  be  necessary,  as  an  oily  solution 
would  clog  an  ordinary  water-spray,  but  the  principle 
of  the  spray  is  the  same,  and  it  is  used  in  the  same  way. 
The  following  is  an  excellent  formula:  Take  of  menthol 
and  carbolic  acid  each  two  grains;  of  eucalyptol,  six  drops; 
and  of  albolene,  two  ounces.  Mix  well,  and  fill  the  spray- 
bottle  one-third  fuU;  it  is  to  be  used  in  the  full  strength. 
Use  only  enough  of  this  spray  to  moisten  the  nose  and 
throat;  by  inhaling  simultaneously  with  squeezing  the 
bulb,  the  very  fine  spray  is  carried  into  the  larynx,  and 
so  is  very  useful  when  there  is  an  irritation  of  that  organ, 
as  shown  by  hoarseness.  If  there  is  only  a  slight  irrita- 
tion of  the  parts,  the  use  of  the  spray  twice  daily  will  be 
sufficient;  the  last  time  should  be  just  before  retiring. 
On  windy  days  it  will  be  a  great  protection  to  the  mucous 
membrane  of  the  throat  to  use  it  just  before  going  out- 
of-doors,  on  the  throat  only.  If  the  inflammation  is  severe, 
the  spray  may  be  used  as  often  as  every  two  hours.  This 
prescription  should  be  put  up  by  a  good  druggist. 

Ear  specialists  condemn  all  nasal  douches  as  dangerous, 
on  account  of  the  possibiHty  of  the  water  being  forced  into 
the  Eustachian  tubes. 

General  Treatment. — First  of  aU,  the  system  must  be 
toned  up  by  the  systematic  use  of  cold  baths,  adapted 
to  each  particular  case,  tonics,  iron,  and  cod-hver  oil. 
It  is  a  grave  mistake  to  allow  these  cases  to  become 


150  PERSONAL  HYGIENE   FOR  WOMEN 

chronic,  as  they  may  be  the  forerunners  of  influenza 
and  even  general  tuberculosis.  They  need  prompt  and 
scientific  treatment,  which  the  physician  alone  is  capable 
of  giving. 

The  Ear. — The  ear  is  divided  into  three  parts — the 
external  ear,  the  middle  ear  or  tympanum,  and  the  internal 
ear  or  labyrinth.  The  internal  ear  is  the  essential  part 
of  the  organ  of  hearing  in  which  the  auditory  nerve  ends. 
Its  structure  is  very  complicated.  The  external  ear  is 
separated  from  the  middle  ear  by  the  tympanic  mem- 
brane or  drumhead.  This  is  a  thin,  small,  membranous 
sheet,  which  is  stretched  tautly  across  the  junction  of 
these  two  cavities,  and  vibrates  inward  and  outward 
between  them.  The  external  ear  collects  and  conducts 
the  waves  of  sound  to  the  tympanum. 

The  middle  ear,  or  tympanum,  is  an  irregular  cavity, 
situated  within  the  bone.  It  is  traversed  by  a  chain  of 
movable  bones,  which  connect  the  drumhead  with  the 
internal  ear,  and  serves  to  convey  vibrations  of  sound  to 
it.  The  middle  ear,  or  drum  cavity,  is  filled  with  air, 
and  communicates  with  the  pharynx  by  means  of  the 
Eustachian  tube.  The  middle  ear  is  lined  throughout 
with  mucous  membrane,  which  is  continuous  with  that  of 
the  throat  and  nose. 

The  Eustachian  tube  is  continuous  with  the  middle 
ear,  and  extends  downward  and  forward  about  an  inch 
to  connect  it  with  the  pharynx,  where  it  opens  by  a 
trumpet-like  expansion,  just  above  the  soft  palate,  at  the 
junction  of  the  throat  and  nose.  It  serves  to  carry  off  the 
excess  of  fluid  from  the  middle  ear  and  to  preserve  the 
equilibrium  of  the  pressure  between  the  gaseous  contents 
of  this  cavity  and  the  atmosphere.  The  walls  of  the 
Eustachian  tube  are  in  close  contact,  but  they  are 
normally  opened  during  every  act  of  swallowing,  yawning, 
etc.,  when  the  air  finds  its  way  into  the  middle  ear.  A 
stoppage  of  the  nose  reverses  the  process,  and  when  the 
tubes  are  not  likewise  stopped  up,  every  swallowing 
motion  draws  air  out  of  the  tubes.     If  the  openings  of  the 


THE   RESPIRATORY  AND   CIRCULATORY   SYSTEMS      151 

tubes  become  closed,  deafness,  dizziness,  and  subjective 
noises  will  result. 

The  middle  ear  is  the  seat  of  about  two-thirds  of  aU 
aural  troubles,  and,  since  much  of  this  could  be  prevented, 
this  becomes  a  matter  of  great  practical  importance. 

Causes  of  Impairment  of  Hearing. — The  majority  of  the 
affections  of  the  middle  ear  originate  from  extensions  of 
catarrhal  inflammations,  from  the  nose  and  throat,  through 
the  Eustachian  tubes.  In  children  adenoids  are  the  most 
frequent  cause  of  deafness.  The  so-called  hereditary- 
deafness  is  probably  due  to  an  inherited  configuration 
of  the  septum  of  the  nose,  a  bending  of  the  septum  to  one 
side,  or  a  tendency  to  catarrhal  affections  of  its  mucous 
membranes. 

Every  cold  in  the  head  tends  to  mechanically  involve 
the  ears,  and,  while  recovery  may  seem  complete,  there 
is  likely  to  be  some  unrelieved  trouble  which  insidiously 
but  steadily  increases — first  one  ear,  and  then  the  other, 
shows  signs  of  defective  hearing.  If  only  one  ear  is  in- 
volved, the  condition  may  progress  seriously  before  the 
patient  is  aware  of  the  trouble. 

Preventive  Measures  Against  Deafness. — From  what  has 
been  said,  it  naturally  f oUows  that  the  preventive  measures 
must  be  chiefly  those  already  given  against  taking  cold. 
If  one  does  take  cold,  instead  of  leaving  it  to  run  its 
course,  as  is  too  often  done,  proper  therapeutic  measures 
should  be  at  once  adopted  to  bring  as  speedy  a  cure  as 
possible. 

Impacted  Ear-wax  and  its  Removal. — A  healthy  ear 
should  never  show  more  than  enough  wax  to  render  the 
hairs  within  soft,  and  the  individual  should  be  uncon- 
scious of  the  wax  coming  away.  Wax  does  not  collect 
in  a  healthy  ear.  When  it  does  occur,  there  is  a  stopped- 
up  feehng  in  the  ears,  due  to  the  occlusion  of  the  meatus 
by  wax. 

The  only  procedure  that  is  safe  to  follow  in  order  to 
remove  the  wax  from  the  ear  is  to  gently  douche  the  ear 
with  warm  water,  at  a  temperature  from  105°  to  110°  F. 


152  PERSONAL  HYGIENE   FOR  WOMEN 

If  this  does  not  suffice,  a  physician  must  be  consulted,  as 
all  efforts  to  remove  the  wax  after  it  has  become  impacted 
are  dangerous  and  futile  except  in  skilled  hands. 

Earache. — The  best  thing  for  the  relief  of  earache  is 
the  external  application  of  heat  by  means  of  a  hot-water 
bag.  If  this  does  not  give  relief,  the  ear  may  be  douched 
with  warm  water.  Earache  can  often  be  prevented,  by 
those  subject  to  it,  by  placing  a  veiy  small  piece  of 
absorbent  cotton  in  the  ear  before  going  out  in  very  high 
winds  or  in  automobiling. 

Impediments  to  Normal  Respiration. — These  are,  for 
the  most  part,  acquired  through  improper  habits  of  posture, 
dress,  lack  of  muscular  and  chest  development.  Other 
impediments  to  respiration  are  a  deviation  of  the  septum 
of  the  nose  to  one  side,  marked  curvature  of  the  spine, 
and  deformities  of  the  chest  which  may  be  the  results  of 
rickets. 

Curvature  of  the  spine  is  frequently  the  result  of  mus- 
cular weakness,  combined  with  faulty  position  at  the  desk. 

The  clothing  must  be  sufficiently  loose  to  admit  of  the 
fullest  possible  chest  expansion;  the  measurements  for 
the  clothing,  and  most  especially  for  corsets,  must  be 
taken  during  full  chest  expansion. 

Heavy  clothing  suspended  from  the  shoulders  is  also 
hurtful,  because  it  renders  impossible  the  expansion  of 
the  apices  of  the  lungs.  Obviously,  all  tight  bands  around 
the  neck  interfere  with  the  respiratory  movements. 

Bodily  position  plays  a  very  important  part  in  main- 
taining the  symmetric  development  of  the  chest  and 
in  the  proper  ventilation  of  the  lungs;  and  this  is  a  matter 
of  the  greatest  importance  to  students,  clerks,  and  writers 
who  spend  a  great  part  of  every  day  at  the  desk. 

The  faulty  attitude,  together  with  the  weak  muscles 
and  the  poor  muscular  development,  are  fruitful  sources 
of  spinal  curvatures  and  flat  chests;  and  free  respiration 
is  interfered  with.  Writing  with  a  pen  is  most  apt  to  be 
accompanied  by  a  peculiarly  cramped  position  of  the 
body,  rendering  normal  respiration  impossible. 


THE  EESPIRATORY  AND   CIRCULATORY   SYSTEMS      153 

The  Correct  Attitude  at  the  Desk. — ^The  chair  should  be 
of  such  a  height  that  the  woman  may  rest  her  feet  firmly 
and  easily  on  the  floor  or  upon  a  foot-rest,  the  seat  being 
deep  enough  from  before  backward  to  accommodate  about 
three-fourths  of  the  length  of  the  thighs,  while  the  back 
of  the  chair  should  be  so  curved  as  to  support  the  spine 
easily  in  its  natural  curves,  both  at  the  waist  and  at  the 
level  of  the  shoulder-blades. 

The  chair  and  desk  should  be  sufficiently  close  together 
so  that  the  student  may  sit  erect  to  read  from  books, 
since  leaning  forward  at  the  desk  causes  round  shoulders, 
flat  chest,  and  short-sightedness.  When  the  desk  and 
chair  are  properly  arranged,  tw^o-thirds  of  the  forearm 
can  be  rested  upon  the  desk  without  raising  the  shoulders. 

In  reading,  the  distance  of  the  book  from  the  eyes  should 
be  twelve  inches,  and  the  book-rest  should  be  inchned, 
sloping  downward  toward  the  reader,  at  about  an  angle 
of  85  degrees. 

If  the  woman  has  any  great  amount  of  writing  to  do, 
she  should  learn  to  use  a  typewriter.  In  using  this 
machine  she  not  only  writes  very  much  more  rapidly 
and  easily,  but  the  position  of  the  body  is  much  more 
erect  than  that  assumed  when  using  the  pen,  and  it  is 
not  nearly  so  fatiguing  to  the  muscles  of  the  hands  and 
arms. 

All  closely  confining  sedentary  occupations,  as  writing, 
sewing,  etc.,  should  be  frequently  interrupted  to  move 
about  for  a  few  minutes,  rest  the  eyes,  and  take  a  few 
deep  breathing  exercises  before  an  open  window;  this 
is  necessary  for  the  eyes  as  well  as  for  the  ventilation  of 
the  lungs. 

Ventilation  of  the  Lungs  and  Breathing  Exercises. 
— Forced  respiration  is  essential  to  completely  change 
the  air  in  the  lungs,  to  maintain  the  elasticity  of  the  lung 
tissue,  and  to  expand  the  chest  in  every  direction.  Only 
in  this  way  can  a  thorough  ventilation  of  the  lungs  take 
place;  a  full  supply  of  oxygen  is  taken  in,  which  stirs 
up,  disinfects,  and  cools  the  stagnant  residual  air,  and 


154  PERSONAL  HYGIENE   FOR  WOMEN 

forced  expiration  expels  the  respiratory  excretions.  One 
of  the  frequent  causes  of  foul  breath  is  lack  of  ventila- 
tion of  the  lungs,  so  that  the  expired  air  becomes  laden 
with  impurities. 

In  normal  breatliing  the  current  of  air  which  passes  in 
and  out  of  the  lungs  travels  through  the  nose,  not  the 
mouth.  The  ingoing  air,  by  exposure  to  the  vascular 
mucous  membrane  of  the  narrow  and  winding  nasal 
passages,  is  warmed  and  moistened,  and  at  the  same  time 
the  mouth  is  protected  from  the  desiccating  effects  of  the 
continual  inroad  of  comparatively  dry  air. 

By  means  of  respiratory  exercises  the  mobility  of  the 
chest  may  be  greatly  augmented;  there  is  a.n  increased 
flexibility  of  the  ribs  and  sternum,  as  well  as  loosening 
of  the  thoracic  joints,  which  may  have  become  stiff,  and 
these  exercises  also  lead  to  a  development  of  the  respiratory- 
muscles. 

In  this  manner  only  can  the  frame  work  of  the  chest 
become  thoroughly  inflated  from  within,  and  thus  all 
parts  of  the  lungs,  which  run  the  risk  of  becoming  in- 
capacitated from  lack  of  use,  be  brought  into  play. 

It  is  highly  important  that  this  thorough  ventila- 
tion of  the  lungs  should  take  place  at  least  three  times 
a  day — the  first  thing  in  the  morning,  while  making  the 
toilet,  again  about  the  middle  of  the  day,  and  at  night 
just  before  retiring. 

To  obtain  the  greatest  benefit  from  these  exercises 
they  must  be  taken  without  corsets,  the  clothing  must  be 
light  and  loose,  and  the  body  lightly  clad.  The  air  in 
the  room  must  be  fresh,  and  after  they  have  been  learned, 
they  can,  as  a  rule,  be  taken  before  an  open  window.  In 
the  morning  they  are  best  taken  just  after  the  cold  bath, 
when,  by  removing  the  impurities  and  fiUing  the  lungs 
with  fresh  air,  and  at  the  same  time  starting  up  a  good 
vigorous  circulation,  they  cause  one  to  begin  the  day 
with  energy  and  zest. 

The  respiratory  movements  are  diminished  during 
sleep,  and  at  the  same  time  there  is  a  large  accumulation 


THE  RESPIRATORY  AND   CIRCULATORY  SYSTEMS      155 

of  blood  in  the  splanchnic  veins,  so  that,  particularly 
when  there  is  any  tendency  to  difficulty  with  the  breathing 
at  night,  the  trouble  is  greatly  lessened  by  filling  the  lungs 
with  pure  air  just  before  retiring. 

It  is  necessary,  first  of  all,  to  learn  the  art  of  breathing, 
to  be  able  to  dissociate  the  clavicular,  the  costal,  and  the 
diaphragmatic.  By  clavicular  breathing  is  meant  the 
raising  of  the  coUar-bone  and  shoulders  as  high  as  possible 
by  means  of  a  slow  but  deep  inspiration — this  expands  the 
apices  of  the  lungs;  costal  breathing  is  the  throwing  out 
and  expanding  the  chest  to  its  utmost  capacity,  and  so 
enlarging  the  chest  in  its  transverse  and  anteroposterior 
diameters;  diaphragmatic  breatliing  is  the  depression  of 
the  diaphragm  and  the  protrusion  of  the  abdomen  with- 
out raising  the  lower  ribs.  The  last  is  the  most  readily 
learned  in  the  supine  position ;  the  bed  supports  the  weight 
of  the  body,  so  that  the  individual  is  able  to  concentrate 
her  entire  attention  on  fix:ing  the  bony  thorax,  depressing 
the  diaphragm,  and  protruding  the  abdomen  at  every  in- 
spiration and  retracting  it  to  the  utmost  with  every  ex- 
piration. This,  of  course,  develops  and  gives  tone  to  the 
abdominal  muscles. 

When  the  woman  has  conquered  these  first  principles 
of  respiration,  she  is  ready  to  put  them  into  practice 
in  the  standing  posture.  They  should  be  learned  before 
a  mirror,  and  after  that  taken  before  an  open  window. 
The  hands  should  be  placed  on  the  hips;  first  elevating 
the  collar-bones  and  the  shoulders  to  the  utmost,  while 
still  holding  the  breath,  she  expands  the  chest,  always 
breathing  in  from  above  downward,  and,  lastly,  the 
diaphragm  is  depressed.  With  the  lungs  thus  expanded 
to  their  utmost  capacity,  the  breath  is  held  as  long  as 
possible,  then  the  lungs  are  emptied  by  an  abrupt  and 
forced  expiration. 

These  exercises  should  be  repeated  at  first  ten  times, 
gradually  increasing  to  thirty  times.  It  is  well  to  take 
one  or  two  ordinary  respirations  between  the  forced 
ones. 


156  PEESONAL  HYGIENE   FOR  WOMEN 

It  will  be  found  that,  as  these  exercises  proceed  and 
the  lungs  are  filled  with  purer  air,  the  breath  can  be  held 
for  a  longer  period  of  time,  and  that  with  practice  the 
length  of  time  that  the  breath  can  be  held  is  greatly 
increased;  it  should  be  held  for  half  a  minute.  Public 
speakers,  singers,  and  divers  are  all  skilful  in  this  respect. 

When  these  simple  breathing  exercises  have  been 
mastered,  breathing  exercises  can  be  combined  with 
other  exercises,  which  have  as  their  aim  the  development 
of  the  muscles  of  the  chest. 

Reading  aloud,  singing,  talking,  laughing,  are  all  good 
exercises  for  developing  the  capacity  of  the  lungs. 

The  Cure  of  Chronic  Bronchitis  by  Deep-breathing 
Exercises. — The  upper  part  of  the  body  must  be  nude 
and  the  exercises  taken  before  a  mirror,  so  that  the 
woman  can  watch  the  movements  of  the  chest  and 
abdomen,  see  that  all  the  hollows  of  the  chest  are  filled 
out  during  forced  inspiration,  and  that  the  muscles  of 
the  abdomen  are  properly  retracted.  For  the  average 
woman  this  last  will  be  the  most  difiicult;  in  beginning 
these  exercises  she  will  find  that  it  will  require  all  her 
concentrated  energy  and  will  power  to  cause  a  retraction 
of  these  disused  muscles. 

Patients  with  chronic  bronchitis  do  not  have  the 
ability  to  perform  forced  respiration  properly.  The 
respirations  are  too  superficial,  and  the  respiratory  move- 
ments are  not  properly  performed. 

As  respiration  is  ordinarily  performed,  the  partial 
expansion  of  the  upper  part  of  the  chest  is  accompanied 
by  a  contraction  of  the  abdominal  muscles,  whereby  the 
diaphragm  is  forced  upward,  with  the  result  that  the 
lower  part  of  the  lungs  remains  very  slightly  expanded, 
whereby  the  circulation  as  well  as  the  removal  of  mucus 
is  imperfectly  performed.  This  lack  of  forced  respiration 
IS  a  frequent  cause  of  acute  bronchitis  running  into  a 
chronic  form. 

In  chronic  bronchitis  it  is  especially  in  the  lower  part 
of  the  lungs  that  stagnation  of  the  secretions  takes  place, 


THE  RESPIRATOEY  AND   CIRCULATORY  SYSTEMS      157 

and  they  can  only  be  dislodged  from  the  mucous  mem- 
brane by  forced  abdominal  expiration  and  the  ascent  of 
the  diaphragm.  This  causes  a  cough  which  expels  the 
mucus,  and  forcible  abdominal  expiration  and  cough 
are  the  only  means  of  drainage  of  the  lower  and  deep- 
seated  parts  of  the  lungs.  Further,  in  forced  respiration 
the  muscle  tissue  of  the  bronchial  tubes  contracts,  which 
certainly  does  not  take  place  in  ordinary  respiration,  but, 
on  the  contrary,  this  tissue  atrophies. 

Other  beneficial  results  from  forced  respiration  are 
increased  oxygenation,  improved  nutrition,  changes  of  a 
mechanical  nature,  ventilation,  and  disinfection  of  the 
lungs,  massage  of  the  lungs  and  pleura,  and  drainage. 

No  other  method  of  treatment  is  so  successful  in  the 
cure  of  chronic  bronchitis  not  dependent  on  disease 
of  the  nose  and  throat.  In  from  two  to  six  weeks  of  treat- 
ment, in  which  there  is  a  profuse  discharge  of  mucus, 
it  will  be  found  that  the  bronchial  tubes  have  cleared  up, 
provided  that  the  patient  is  supplied  with  an  abundant 
supply  of  fresh  air  day  and  night.  Methodically  practised, 
deep  breathing  is  not  only  the  surest  cure,  but  also  the 
safest  stimulating  expectorant. 

Relation  of  Colds  and  Influenza  to  Pneumonia  and 
Tuberculosis  and  their  Prevention. — We  have  already 
seen  that  bacilli  are  not  only  the  cause  of  acute  infec- 
tions, but  also  of  chronic  bronchitis,  and  that  this  was 
especially  true  of  the  bacillus  of  influenza  and  the  pneu- 
mococcus  of  pneumonia. 

It  is  weU  known  that  influenza  is  an  infectious  disease, 
which  rapidly  spreads  through  the  family  and  the  com- 
munity, but  it  is  not  so  well  known  that  the  so-called 
"common  colds,"  ordinary  sore  throat,  and  tonsilhtis 
are  also  highly  contagious.  The  infection  is  carried  from 
one  person  to  another  by  direct  contagion;  the  air  is 
being  constantly  sprayed  with  the  germs  of  disease  in 
talking,  laughing,  sneezing,  and  coughing.  In  coughing 
and  sneezing  it  is  not  sufficient  to  hold  the  hand  before 
the  mouth — a  handkerchief  must  be  used  for  this  purpose. 


158  PERSONAL  HYGIENE   FOR  WOMEN 

Colds  are  among  the  most  frequent  of  the  so-called 
minor  ailments  in  this  countiy.  The  causes  are  the  over- 
heating of  the  houses,  the  great  drATiess  of  the  air,  badly 
ventilated  houses  and  public  assembly  rooms,  which 
render  people  very  susceptible  to  the  great  variations  in 
temperature. 

Prophylaxis,  or  the  prevention  of  colds,  combine  aU  those 
measures  which  promote  the  general  tone  of  the  system, 
and  may  be  said  to  embrace  all  the  elements  of  personal 
hygiene.  Good  digestion  and  proper  nourishment  of 
the  body  with  suitable  food;  the  proper  ventilation  of 
houses,  all  public  buildings  and  conveyances,  for  in  these 
latter  the  public  are  brought  into  very  close  contact  with 
their  feUow-men. 

Local  prophylaxis  would  consist  in  the  toilet  of  the 
nose  and  throat — the  removing  of  adenoids  and  enlarged 
tonsils. 

The  individual  must  remember  that  she  can  reinfect 
herself;  for  this  reason,  an  abundant  supply  of  hand- 
kerchiefs must  be  used;  they  should  be  placed  in  a 
handkerchief  bag  and  washed  separately.  Packs  of  cards 
should  be  thrown  away  before  they  become  soiled.  Sprays 
and  atomizers  must  be  individual  property,  and  be  kept 
thoroughly  cleansed. 

With  the  exception  of  deep-seated  chest  colds,  in  the 
early  stages  a  cold  may  often  be  nipped  in  the  bud  by  a 
few  hours  of  hard  sudorific  work  in  the  open  air.  In  half 
a  day  the  nasal  ducts  and  respiratory  system  will  throw 
off  irritating  matter  that  would  take  much  longer  time 
if  the  patient  remained  indoors  and  relied  on  the  action 
of  drugs  alone. 

Treatment. — Other  methods  of  treatment  are  a  hot 
tub-bath  on  retiring,  an  active  but  not  too  severe  cathartic, 
as  two  grains  of  calomel,  taken  just  before  going  to  bed, 
and,  if  the  individual  is  chiUy,  a  hot  lemonade  should  be 
taken  at  the  same  time.  Both  the  cathartic  and  the 
free  perspiration  wiU  aid  in  relieving  the  internal  con- 
gestion   and   thus   aid   in   its  abortion.     A  cold   sponge 


THE  RESPIRATORY  AND  CIRCULATORY  SYSTEMS      159 

should  be  taken  the  following  morning  to  tone  up  the 
system.  Turkish  baths  are  also  useful  in  breaking  up 
colds;  again,  the  precaution  must  be  taken  to  avoid  chill- 
ing on  leaving  the  bath. 

The  following  tablet  is  a  very  simple  and  very  efficacious 
remedy  for  breaking  up  a  cold  in  the  early  stages:  Take 
of  powdered  camphor  |  gr.;  of  the  sulphate  of  quinin 
i  gr. ;  and  of  the  fluidextract  of  belladonna  root  |  minim. 
This  should  be  well  mixed,  and  made  up  into  one  tablet 
or  a  capsule.  One  tablet  is  taken  every  half-hour,  until 
four  doses  have  been  taken;  after  that  one  tablet  every 
three  hours,  until  the  running  of  the  nose  has  ceased, 
which  generally  occurs  within  twenty-four  hours.  If 
there  is  not  marked  improvement  at  the  end  of  this  time, 
or  if  there  is  any  fever,  a  physician  should  be  consulted 
at  once. 

Quinin,  when  given  alone  to  abort  colds,  must  be  given 
in  sufficiently  large  doses  to  produce  cinchonism,  the 
subjective  symptom  of  which  is  a  slight  deafness  or 
ringing  of  the  ears.  The  natural  tendency  of  cold  is  to 
cause  inflammation  of  the  middle  ear,  and  since  the  use 
of  quinin  in  large  doses  causes  a  congestion,  and  so  pre- 
disposes to  inflammation  of  the  middle  ear,  its  use  should 
be  avoided. 

The  great  amount  of  illness  and  mortality  from  pneu- 
monia during  and  following  epidemics  of  influenza  is 
too  familiar  to  the  public  to  need  more  than  mentioning. 
The  patient  is  so  rapidly  and  extremely  prostrated  by 
the  attack  of  influenza  as  to  be  susceptible  to  the  ready 
action  of  the  pneumococcus,  which,  as  we  have  seen,  is 
ever  present,  and  the  extension  of  the  inflammation 
from  the  fine  bronchial  tubes  to  the  air-cells  of  the  lungs 
rapidly  takes  place.  In  the  exhausted  condition  of  the 
patient  she  is  not  able  to  resist  this  invasion,  the  heart 
is  already  weakened,  and  death  frequently  rapidly  ensues 
as  the  immediate  result  of  heart  failure. 

The  Prevention  of  Tuberculosis. — The  tubercle 
bacillus  is  practically  ubiquitous,  and  the  prevalence  of 


160  PERSONAL  HYGIENE   FOR  WOMEN 

tuberculosis  is  universal.  Hence  it  is  imperative  to 
raise  the  resistance  of  the  individual  in  every  way  pos- 
sible, as  well  as  to  Hmit  the  spread  of  the  infection.  This 
means  the  employment  of  all  the  resources  of  pubhc  and 
personal  hygiene,  pubHc  and  private  sanitation,  and  the 
education  of  the  public  in  how  the  disease  is  disseminated, 
and  how  its  spread  may  be  prevented;  also  the  teaching 
of  the  individual,  her  duty  to  the  family  and  society,  as 
well  as  to  herself,  in  order  not  to  spread  the  contagion. 

Tuberculosis  attacks  the  crippled  and  poorly  developed 
lung  just  as  surely  as  it  shuns  the  one  which  is  fully  ex- 
panded and  in  constant  and  active  service.  Numerous 
observations  have  established  the  existence  of  a  constant 
ratio  between  tuberculosis  of  the  lungs  and  deficient 
chest  expansion. 

Diet. — The  doctrine  has  been  growing  among  the  laity 
that  the  child's  hkes  and  disKkes  should  determine  what 
food  it  should  eat.  Thus  a  finical  taste  is  cultivated 
and  a  lack  of  proper  nourishment  follows,  and  it  is  this 
finical  diet  class  of  people  which  forms  a  large  percentage 
of  tuberculous  invahds.  It  has  long  been  recognized 
that  a  proper  diet  and  the  tolerance  of  it  is  of  the  utmost 
importance  in  the  treatment  of  tuberculous  patients, 
but  from  the  foregoing  it  would  appear  that  a  proper 
diet  throughout  fife  is  also  of  the  utmost  importance 
in  the  prevention  of  disease;  a  sufficiency,  not  only  as  to 
quantity,  but  also  as  regards  variety. 

It  is  the  patient  who  can  eat  everything  who  stands  a 
good  chance  of  getting  well.  So,  too,  it  is  the  individual 
whose  diet  for  years  has  been  perverse,  who  could  not 
eat  meat,  to  whom  eggs  were  distasteful,  who  could  not 
stand  milk,  who  was  infected  with  the  vegetarian  fad, 
or  the  two-meal-a-day  fad,  who  stands  a  fair  chance  of 
falling  a  victim  to  tuberculosis,  through  a  lowered  tone 
of  the  system,  because  it  offers  but  a  feeble  resistance 
to  a  powerful  and  insidious  enemy.  And  the  mode  of  the 
preparation  of  the  food  is  an  equally  important  factor. 
It  has  been  shown  that  the  poor  cooking  among  the  lower 


THE   RESPIRATORY  AND   CIRCULATORY  SYSTEMS      161 

classes  is  a  powerful  predisposing  cause  to  intemperance 
and  tuberculosis. 

Influenza  is  a  frequent  and  important  agent  in  bringing 
to  light  latent  tuberculosis,  and  must  be  classed  as  an 
important  exciting  if  not  predisposing  cause.  Low, 
damp  climates  predispose  to  the  infection  by  lowering 
the  vitality.  Tuberculosis  is  more  prevalent  in  cities 
than  in  rural  communities,  due  to  the  manner  of  housing 
and  the  character  of  the  occupation. 

Sumimary  of  the  Present  Views  of  Infection. — The  doctrine 
of  inherited  and  acquired  susceptibiUty  still  holds  sway; 
next,  that  all  infants  are  susceptible,  and  that  suscepti- 
bihty  lessens  with  increase  in  age;  that  adults  are  com- 
paratively insusceptible  when  free  from  general  and  local 
lowered  resistance  and  repeated  and  prolonged  exposure. 

As  to  the  source  of  infection,  the  consensus  of  opinion 
and  ascertained  facts  point  to  the  sputum  as  of  over- 
whelming importance;  cow's  milk  is  an  important  factor; 
the  food  may  be  infected  directly  by  coughing,  or  the 
dirt  and  dust  from  the  floor  and  hands;  the  fingers  and 
many  other  objects  that  find  their  way  into  the  child's 
mouth  are  sources  of  danger.  To  adults,  both  dust  and 
moist  droplets  are  more  often  the  source  of  infection  than 
infected  food. 

Expectoration.  —  Careless  expectoration  is  the  chief 
source  of  infection.  Laws  should  be  passed  and  enforced 
prohibiting  the  expectoration  on  pavements,  stairways, 
in  all  public  conveyances,  and  all  pubHc  places. 

The  danger  of  infection  from  tuberculous  house  servants 
has  not  been  sufficiently  appreciated.  A  chronic  cough 
in  the  case  of  a  servant  should  be  at  once  investigated 
by  the  family  physician.  Servants  should  be  taught 
the  necessity  for  washing  the  hands  before  touching  the 
food  or  cooking  utensils.  The  condition  of  their  rooms, 
clothing,  bathing,  and  other  personal  habits  should  be 
closely  investigated,  and  personal  cleanHness  should  be 
demanded  as  a  sine  qua  non  for  obtaining  or  keeping  a 
situation. 
11 


162  PERSONAL   HYGIENE   FOR  WOMEN 

Since  it  is  a  well-known  fact  that  tuberculosis  can  be 
acquired  from  the  occupation  of  houses  and  rooms 
formerly  occupied  by  tuberculosis  patients,  it  has  been 
suggested  that  a  clean  bill  of  health  should  be  demanded 
of  the  owner  of  the  house  before  renting  it;  that  is, 
a  certificate  from  the  Board  of  Health,  that  no  case  of 
infection  has  existed  in  the  house,  or  that  it  has  been 
properly  disinfected  since  that  time.  If  such  a  move- 
ment became  popular,  landlords  would  be  obliged  to 
furnish  these  bills  of  health  in  self-defense.  Since  the 
Boards  of  Health  demand  the  reporting  of  all  cases  of 
tuberculosis,  this  scheme  is  by  no  means  impracticable  or 
Utopian. 

The  tubercle  bacillus  is  not  destroyed  by  any  degree 
of  cold,  but  both  hght  and  sunlight  are  distinctly  injurious 
to  these  bacteria.  The  lowest  fatal  temperature  to  the 
tubercle  bacillus  is  131°  F.  of  moist  heat,  acting  for  a 
period  of  six  hours.  The  thermal  death-point  of  tubercle 
baciUi  in  milk  is  of  great  practical  importance,  and  many 
experiments  have  been  made  which  have  determined  that 
a  temperature  of  from  140°  to  167°  F.,  was  sufficient  if 
continued  for  one  hour.  If  it  is  desired  to  pasteurize  the 
milk,  it  should  be  placed  in  a  closed  bottle  or  stirred  and 
heated  for  at  least  twenty  minutes  at  a  temperature  of 
149°  F. 

Disinfection. — The  use  of  formaldehyd  gas  has  practi- 
cally displaced  the  use  of  sulphur  for  the  fumigation  of 
rooms,  as  well  as  for  the  disinfection  of  furniture  and 
clothing.  For  this  purpose  a  moist  vapor  used  in  a  sealed 
room  is  essential. 

At  least  8  ounces  of  the  commercial  40  per  cent,  formalin 
should  be  used  for  each  1000  cubic  feet  of  air  content. 
The  most  efficient  method  is  that  used  by  Biggs,  of  New 
York,  which  is  as  follows:  For  an  ordinary  room,  1000 
cubic  feet,  1  pound  of  lime,  8  fluidounces  of  formalin,  and 
from  2J  to  3  fluidounces  of  commercial  sulphuric  acid 
are  required.  All  openings  but  the  door  are  sealed.  The 
formalin  is  poured  into  an  empty  water-pitcher,  4  ounces 


THE   RESPIRATORY   AND   CIRCULATORY  SYSTEMS      163 

of  water  are  added,  and  then  the  sulphuric  acid  is  poured 
slowly  in.  The  lime  is  placed  in  a  china  or  earthenware 
wash-basin  on  the  floor  upon  newspapers;  all  water  is 
removed  from  the  room.  All  drawers  and  cupboards 
opened;  the  mattresses  stood  on  end;  and  the  mixture 
poured  quickly  upon  the  lime,  when  the  door  is  sealed. 
The  sulphuric  acid  may  be  packed  in  a  tin  bucket  contain- 
ing the  lime,  and,  with  the  formalin  in  a  separate  bottle, 
may  be  used  by  any  person  of  ordinary  intelligence. 
The  room  should  remain  closed  from  twelve  to  eighteen 
hours.  It  must  not  be  lost  sight  of  that  after  disinfection 
by  means  of  formaHn  a  thorough  cleansing  is  imperative. 
A  room  which  has  been  thoroughly  cleaned  and  carbolized 
is  safer  than  a  room  which  has  been  disinfected  with 
formalin  and  not  properly  cleaned. 

After  death  or  removal  the  entire  place  should  be 
renovated.  Besides  disinfection  and  scrubbing  the 
painted  woodwork  with  a  solution  of  hot  soda  water, 
the  walls  should  be  repainted  or  repapered,  and  the  wood- 
word  repainted. 

Rugs,  bedding,  pillows,  and  clothing  should  be  disin- 
fected by  hanging  up  in  the  room  while  it  is  undergoing 
disinfection.  Books  and  all  articles  of  small  value  should 
be  burned.     All  soiled  linen  should  be  boiled. 

The  Kidneys  and  their  Function. — The  kidneys  are 
the  secretory  organs  of  the  uiine;  they  are  two  in  number, 
and  are  the  largest  tubular  glands  in  the  body.  They 
are  deeply  seated  in  the  lumbar  region,  lying  one  on  each 
side  of  the  vertebral  column;  the  kidneys  extend  from 
the  eleventh  rib  nearly  to  the  crest  of  the  pelvis.  They 
are  usually  embedded  in  a  considerable  quantity  of  fat, 
which  is  the  chief  factor  in  holding  them  in  position, 
aided  to  some  extent  by  the  large  blood-vessels  with 
which  they  are  connected.  The  kidneys  are  oblong 
bodies  and  measure  about  4  inches  in  length,  2J  inches 
in  breadth,  and  over  1  inch  in  thickness.  Their  weight 
is  about  4J  ounces. 

As  an  excretory   organ  the  kidney  probably  stands 


164  PERSONAL  HYGIENE  FOR  WOMEN 

second  to  the  alimentary  canal;  it  surpasses  in  importance 
the  skin,  whose  total  excretion  of  water  it  equals.  The 
abnormal  substances  appearing  in  the  urine  are  often 
not  the  products  of  disease  of  the  kidneys,  but  of  some  other 
organ  or  system. 

The  kidneys  excrete  and  put  the  finishing  touches 
upon  the  urinary  fluid;  they  act  at  the  end  of  the  meta- 
bolic course,  both  as  active  and  as  passive  agents.  While 
to  some  extent  the  kidneys  are  mechanical  contrivances, 
mere  filters,  so  to  speak,  they  are  to  a  far  greater  degree 
active,  specific  glands.  The  renal  epitheHum  has  the 
power  of  synthesis,  and  builds  up  complex  substances 
that  are  not  apparent  as  such  in  the  blood  or  lymph,  as 
well  as  the  power  of  analysis  or  breaking  down  of  sub- 
stances. These  changes  are  due  to  the  formation  in 
the  tubular  cell  of  an  enzyme,  which  we  call  histozyme. 
The  kidney  is  the  end  link  in  the  vascular  chain,  and  the 
daily  performance  of  healthy  kidneys  is  no  doubt  a 
combination  of  the  mechanical  and  the  vital  processes. 

The  Secretion  of  the  Urine. — In  a  perfectly  normal  being 
the  problems  of  waste  and  repair  are  balanced  to  a  nicety. 
As  we  know,  the  tissues  of  the  body  are  bathed  in  lymph 
containing  in  solution  the  compounds  that  are  necessary 
for  their  nourishment — proteids,  carbohydrates,  fats, 
salts,  and  gases.  Waste  follows  in  direct  proportion  to 
the  activity  of  the  tissues.  The  worn-out,  effete  material 
first  finds  its  way  into  the  lymph,  and  from  it  into  the 
blood-stream,  to  be  later  ehminated  from  the  economy, 
else  deleterious  results  will  follow  their  retention  in  the 
body.  It  is  by  the  selective  action  of  the  cells  of  the 
various  glands  of  the  body  that  these  useless  substances 
are  removed  from  the  blood,  and  converted  into  such 
forms  as  can  be  readily  excreted.  In  the  main,  the 
products  to  be  removed  are  urea  and  the  allied  nitrogenous 
bodies — carbon  dioxid,  salts,  and  water.  These  organs 
are  of  \'ital  importance,  since  nearly  all  of  the  waste- 
products  containing  nitrogen  are  eliminated  in  the  urine. 

The  most  easily  understood   function  of  the  kidneys 


THE  RESPIRATORY  AND   CIRCULATORY  SYSTEMS      165 

is  the  excretion  of  the  urinary  water;  this  varies  in  amount 
with  the  rapidity  of  flow  through  the  renal  vessels  and 
to  some  extent  on  the  blood-pressure. 

The  separation  of  the  solid  substances  of  the  urine 
form  the  next  function  of  the  kidneys,  and  these  substances 


Fig.  11. — Relation  of  kidneys  to  heart  and  great  blood-vessels:   A, 
Heart;  B,  B,  kidneys;  C,  bladder  (after  Quain). 


fall  into  two  groups — inherently  useful  materials,  which 
are  in  excess  or  which  have  served  their  purpose,  and 
substances  which  are  inherently  harmful.  The  latter  class 
embrace  many  end-products  of  metabolism,  which  we  are 
accustomed  to  consider  as  normal  constituents  of  the  urine. 


166  PERSONAL  HYGIENE   FOR   WOMEN 

The  analytic  study  of  the  urine  is  of  great  value  to  the 
physician  and  surgeon,  because  of  the  knowledge  which 
it  gives  concerning  the  processes  of  metabolism  occurring 
within  the  body.  The  nature  and  amounts  of  the  various 
end-products  of  metabolism  are  carefully  investigated  as 
they  occur  in  the  urine,  whether  they  be  normal  or  patho- 
logic. 

The  Urine. — The  normal  human  urine  recently  passed  is 
a  clear  liquid,  of  a  straw  color,  with  an  average  specific 
gravity  of  1020,  the  specific  gravity  indicating  the  amount 
of  solids  contained  in  the  urine.  It  is  acid  in  reaction. 
The  quantity  for  twenty-four  hours  is  50  ounces,  or 
about  3  pints,  depending  on  the  amount  of  water  ingested. 
During  sleep  the  amount  secreted  is  less  than  at  other 
times.  The  amount  of  urine  is  decreased  after  profuse 
sweating,  diarrhea,  thirst,  diminution  in  the  blood-pressure, 
and  after  severe  hemorrhage.  When  the  body  temper- 
ature is  considerably  higher  than  normal,  the  amount  of 
urine  is  again  diminished  in  quantity. 

Urea  forms  nearly  one-half  of  the  solids  in  normal  urine 
and  nearly  one-half  of  the  urea  is  nitrogen.  It  is  the 
principal  representative  of  the  waste  of  the  nitrogenous 
tissues.  The  chief  source  of  urea  is  from  the  metabolism 
of  the  muscles;  the  ingestion  of  a  large  amount  of  proteid 
food  stimulates  metabolism.  The  quantity  of  urea 
passed  in  the  twenty-four  hours  is  about  500  grains. 

The  uric-acid  constituent  is  very  small,  and  in  the 
human  urine  scarcely  reaches  0.03  per  cent,  of  the  solids. 
Lack  of  exercise  leads  to  an  increased  formation  of  uric 
acid  by  a  lessening  of  the  oxidation  of  the  tissues.  In 
gout  the  amount  of  uric  acid  excreted  is  abnormally  small, 
because  it  accumulates  in  the  blood  and  tissues.  The 
brick-dust  deposit  sometimes  seen  in  the  urine  is  composed 
chiefly  of  the  urate  of  sodium.  The  average  daily  amount 
of  uric  acid  passed  in  the  human  urine  is  about  7  grains. 
The  excretion  of  uric  acid  may  be  increased  by  drinking 
copious  drafts  of  water. 

Toxicity  of  the  Urine. — After  the  removal  of  both  kid- 


THE  RESPIRATORY   AND   CIRCULATORY   SYSTEMS      167 

neys  the  animal  dies  of  uremia;  that  is,  there  is  an  accu- 
mulation of  urinary  products  in  the  blood.  The  removal 
of  one  kidney  is  not  necessarily  fatal,  and  women  have 
so  lived  very  comfortably  for  many  years.  A  human 
being  excretes  enough  poisonous  material  by  the  kidneys 
in  two  days  to  cause  death. 

The  Urinary  Excretory  Apparatus. — After  the  urine 
has  been  secreted  by  the  kidneys  it  must  be  carried  away 
from  the  body,  so  that  the  economy  may  not  suffer  from 
the  resorption  of  the  contained  toxic  principles.  The 
excretory  apparatus  comprises  the  ureters,  the  bladder, 
and  the  urethra. 

The  ureters  are  two  cylindric  tubes  of  the  diameter 
of  a  goose-quill  and  about  15  inches  long.  They  make 
their  exit  from  the  inner  border  of  the  kidney,  and  pass 
downward  and  inward  toward  the  median  line,  to  empty 
into  the  base  of  the  bladder  by  a  slit-like  orifice. 

The  bladder  is  the  reservoir  for  the  urine.  It  is  a 
musculomembranous  sac,  situated  in  the  pelvis,  and  in 
the  female  it  is  in  front  of  the  uterus  and  above  the  vagina. 
It  normally  contains  one  pint.  It  should  be  emptied  four 
times  a  day.  If  it  is  allowed  to  go  longer  than  this,  it 
becomes  overdistended,  and  is  apt  to  displace  the  uterus 
backward,  and  the  bladder-walls  themselves  become 
weakened. 

The  Physiology  of  the  Female  Generative  Organs. — 
The  internal  and  essential  organs  of  generation  are  the 
uterus,  ovaries,  and  the  Fallopian  tubes.  These  organs 
have  to  do  with  the  process  of  ovulation,  menstruation, 
and  reproduction. 

The  Ovaries. — These  are  two  small  bodies  of  an  almond 
shape,  and  lie  one  on  either  side  of  the  uterus.  The  bulk 
of  the  organ  consists  of  connective  tissue,  in  which  lie 
embedded  the  Graafian  follicles,  or  ovisacs,  in  which  the 
ova  are  contained. 

During  the  child-bearing  period,  or  from  about  the  age 
of  fifteen  to  forty-five  years,  the  development  of  the 
Graafian  follicles  and  the  discharge  of  the  ova  are  con- 


168  PERSONAL  HYGIENE  FOR   WOMEN 

tinually  taking  place.  The  liberation  of  the  ova  usually 
takes  place  at  definite  times,  which,  in  general,  coincide 
with  the  menstrual  epochs,  one  or  more  ova  being  set 
free  at  each  period,  but  this  is  by  no  means  invariable. 

The  Uterus. — The  virgin  uterus  is  a  small,  hollow, 
muscular  organ,  somewhat  pear  shaped,  whose  cavity  is 
about  li  inches  deep.  The  uterus  is  situated  in  the 
middle  of  the  pelvic  cavity,  between  the  bladder  and  the 
lower  bowel.  It  is  held  in  position  by  broad  elastic 
bands,  which  go  to  different  sides  of  the  pelvis;  it  is  also 
in  part  supported  by  the  structures  below  and  above  it; 
but  so  loosely  is  the  utenis  held  that  it  is  easily  pushed 
about,  as,  for  instance,  by  a  full  bladder  or  a  packed 
bowel,  and  persistently  allowing  the  bladder  to  become 
overful,  and  failure  to  have  a  daily  evacuation  of  the 
bowels,  are  prolific  sources  of  displacements  of  the  womb. 

Respiratory  Movements  of  the  Uterus. — When  no  constric- 
tions are  placed  about  the  waist,  the  uterus  moves  freely 
up  and  down  with  every  respiration.  So  distinctly,  and 
with  such  regularity,  do  these  movements  occur  that  an 
operator,  by  watching  the  movements  of  the  uterus, 
can  tell  the  effect  that  the  anesthetic  is  having  on  the 
patient's  breathing.  These  so-called  respiratory  move- 
ments play  a  very  important  role  in  the  circulation  of  the 
uterus,  and  in  the  return  of  the  venous  blood  to  the  heart. 

Anything  which  interferes  with  these  movements,  as 
the  wearing  of  corsets  or  of  tight  bands  about  the  waist, 
prevents  the  free  return  of  the  venous  blood.  The  utems 
becomes  congested,  and  through  the  constant  abnormal 
weight  of  the  organ  itself,  as  well  as  by  the  pressing  down 
upon  it  from  above  of  the  superincumbent  organs,  the 
uterus  is  pushed  down  below  its  normal  position,  the 
hgaments  whose  duty  it  is  to  hold  it  up  become  relaxed, 
and  the  unhappy  woman  suffers  all  the  agonies  that  are 
attendant  on  the  "falling  of  the  womb."  For  this  reason 
the  disorder  is  frequently  met  with  in  women  who  have 
never  borne  children  as  well  as  in  those  who  have. 

The  Functions   of  the    Uterus. — The   function   of   the 


THE  RESPIRATORY  AND   CIRCULATORy  SYSTEMS      169 

uterus  is  to  provide  a  favorable  place  for  tlie  reception 
of  the  product  of  conception,  where  it  may  be  protected 
and  nourished  during  the  period  of  its  development. 
The  purpose  of  menstruation  is  to  keep  the  uterus  in 
suitable  condition  for  the  reception  of  this  product  of 
conception  at  any  time.  It  is  now  known  that  the 
menstrual  flow  is  not  the  whole  of  menstruation,  and  that 
the  changes  going  on  in  the  uterus  are  almost  as  continuous 
as  the  process  of  digestion. 

Average  Duration  of  the  Menstrual  Flow. — The  average 
duration  of  the  menstrual  flow  is  five  days,  although 
the  variations  are  considerable  in  healthy  women.  A 
flow  lasting  any  place  from  two  to  six  days  is  perfectly 
consistent  with  health,  but  a  flow  continuing  less  than 
two  days  or  more  than  six  days  generally  indicates  a 
local  or  general  disease. 

Character  of  the  Menstrual  Flow. — For  the  first  few 
hours,  or  perhaps  for  the  first  day,  the  flow  is  usually 
slight  in  quantity  and  hght  in  color;  on  the  second  and 
third  day  the  flow  reaches  its  height,  and  is  profuse  and 
dark  in  color,  but  it  should  never  be  clotted;  after  this 
it  generally  ceases.  The  amount  of  the  flow  varies  from 
5  to  10  ounces.  If  less  than  5  or  6,  or  more  than  18 
napkins,  are  pretty  well  saturated  through,  the  amount 
may  be  considered  abnormal. 

Premonitory  Symptoms  of  the  Flow. — The  premonitory 
symptoms  of  the  monthly  flow  should  not  be  so  marked 
as  to  cause  the  individual  any  discomfort.  The  first 
indication  of  the  return  of  the  period  should  be  the  flow. 
There  is  generally  a  feeling  of  abdominal  fulness,  with 
some  lassitude  and  sometimes  shght  headache.  The 
temperature  is  lower  and  the  pulse  is  slower  than  at  other 
times.  This  lowered  tone  of  the  system  is  an  additional 
reason  for  increased  care  against  exposure  in  wet  or  cold 
weather. 

Hygiene  of  Menstruation. — During  the  menstrual 
period  all  cold  baths  must  be  strictly  prohibited,  whether 
tub-baths  or  cold  sponges.    The  reason  for  this  is  that  the 


170  PERSONAL  HYGIENE  FOR  WOMEN 

application  of  cold  to  the  surface  causes  a  driving  in  of 
the  blood  from  the  exterior  of  the  body  to  the  internal 
organs,  and,  at  the  time  of  the  menstinal  periods,  there 
is  already  a  congested  condition  of  the  pelvic  organs, 
and  it  must  be  remembered  that  congestion  is  the  first 
stage  of  inflammation. 

Hot  or  warm  sponge  baths  may  be  taken  throughout 
the  period,  and  the  vulva  should  be  bathed  with  warm 
water  twice  a  day  throughout  the  entire  period  of  the 
flow,  as  this  not  only  removes  the  clotted  blood  before 
it  decomposes  and  becomes  the  source  of  irritation,  but 
also  removes  other  irritating  matters,  and  prevents  the 
nervousness  that  is  caused  by  local  irritation. 

Another  question  which  is  still  sub  judice  is  the  necessity 
for  and  the  frequency  with  which  vaginal  douches  should 
be  taken;  all  physicians  are  agreed  that  a  vaginal  douche, 
taken  immediately  after  the  menstrual  period,  is  beneficial, 
as  it  removes  all  of  the  debris  of  the  flow,  which  is  some- 
times very  irritating. 

Exercise. — A  moderate  amount  of  exercise  should  be 
taken  eveiy  day;  this  is  needed  now  quite  as  much  as 
at  any  other  time,  and  only  good  can  result  from  it, 
and  no  harm  comes  of  a  woman  going  out  in  the  rain  or 
the  cold  weather.  As  has  been  sho"v\m,  the  menstrual 
process  is  going  on  for  a  large  part  of  the  time,  and  the  flow 
is  only  the  external  appearance,  but  during  the  time  of 
the  flow  the  woman  must  be  unusually  careful  not  to 
get  her  feet  wet  or  sit  down  with  damp  clothing  on. 
Violent  exercise  of  all  kinds  is  to  be  prohibited  at  this 
time,  as  dancing,  bicycling,  gymnastics,  and  walks  of 
over  three  miles.  The  reason  for  this  is  very  obvious: 
the  uterus  has  now  reached  the  height  of  its  turgescence, 
and  is  heavier  than  at  any  other  time,  hence  the  danger 
that  displacements  or  a  veiy  profuse  flow  would  be  caused 
by  any  kind  of  violent  exercise. 

Treatment. — If  the  woman  has  been  so  unfortunate 
as  to  have  been  caught  out  in  a  heavy  rain,  so  that  her 
clothes  have  been  wet  through,  or  if  in  the  cold  weather 


THE   RESPIRATOEY   AND   CIRCULATORY  SYSTEMS      171 

she  should  come  into  the  house  thoroughly  chilled,  the 
best  thing  to  do  is  to  take  off  her  wet  things  as  quickly 
as  possible;  be  well  rubbed  down  with  hot  rough  towels; 
drink  a  cup  of  hot  tea,  and  go  to  bed  at  once,  with  a  hot- 
water  bag  placed  over  the  abdomen  or  under  the  small 
of  the  back.  She  should  remain  in  bed  until  the  next 
morning,  to  the  end  that  the  circulation  may  regain  its 
equilibrium  as  quickly  as  possible  by  the  immediate 
relief  of  the  pelvic  congestion. 

If  this  exposure  should  have  caused  the  sudden  cessa- 
tion of  the  flow,  a  hot  mustard  foot-bath  should  be  taken. 
One  tablespoonful  of  ground  mustard  is  used  to  the 
gallon  of  water,  as  hot  as  it  can  be  borne;  the  pail  should 
be  made  as  nearly  full  as  possible,  without  nmning  over, 
and  a  blanket  wrapped  about  the  pail  and  woman,  so  as 
to  cause  a  profuse  perspiration;  this  should  be  kept  up 
for  ten  minutes;  as  the  water  cools  off,  hot  water  may  be 
added. 

Profuse  menstruation,  painful  menstruation,  and  scanty, 
very  slight,  or  irregular  flow  are  aU  abnormal  conditions 
that  are  due  to  some  abnoraial  or  pathologic  causes,  and 
a  good  gynecologist  should  be  at  once  consulted,  so  that 
not  only  suffering  may  be  prevented,  but  that  serious 
consequences  to  the  general  health  may  be  averted. 


CHAPTER  V 

THE   NERVOUS  SYSTEM  AS  THE  BALANCE  OF 
POWER  IN  THE  BODY 

The  Brain  the  Master  Organ  of  the  Body;  the  Functions  of  the 
Brain;  Habit  and  Automatism;  the  Physiology  of  the  Brain  and 
Nervous  System;  the  Hygiene  of  Work;  the  Toxins  of  Fatigue; 
Overwork;  Signs  of  Overwork;  Nature's  Restoratives;  Avocation; 
the  Physiologic  Necessity  for  Laughter;  Vacations  and  Health; 
Sleep;  Insomnia. 

The  Eyes;  Eye-strain;  Description  of  the  Visual  Apparatus; 
Optical  Defects  and  Their  Correction;  the  Mechanism  of  Eye-strain; 
Local  Symptoms  of  Eye-strain;  Artificial  Lighting;  Hygienic 
Precautions  in  Reading  and  Sewing;  Injuries  to  the  Eyes;  Symp- 
toms and  Treatment  of  Conjvmctivitis;  Trachoma;  Styes. 

Fvmctional  Nervous  Disorders,  Headache;  Neurasthenia. 

The  Brain  the   Master  Organ  of  the  Body. — The 

brain  is  not  only  the  most  important  organ  in  the  body, 
but  its  essential  organ,  for  the  sake  of  which  all  the  other 
organs  and  tissues  exist,  and  it  is  the  master  of  the  whole. 
It  not  only  receives  help  from  every  other  organ,  but 
it  also  largely  controls  the  working  of  each.  By  its  mental 
action  alone  it  can  hurry  the  heart's  beat  or  slow  its  pace; 
it  can  make  the  skin  shrivel  or  flush;  it  can  quicken  or 
stop  digestion;  it  can  stop  or  change  the  character  of  all 
secretions;  it  can  arrest  or  improve  the  general  nutrition. 
Every  organ  and  every  vital  process  is  represented  in  the 
structure  of  the  brain,  by  special  centers  and  groups  of 
cells  that  have  a  direct  relation  with  such  organs  and 
processes,  and  through  which  they  are  controlled. 

The  Functions  of  the  Brain. — The  brain  may  be  said 
to  have  four  chief  functions;  the  first  is  that  of  motion; 
it  presides  over  and  stimulates  all  the  voluntary  muscular 
movements  of  the  body,  regulating  their  force,  and  co- 
ordinating in  their  working  the  different  groups  of  muscles 

172 


NERVOUS  SYSTEM   BALANCE  OF   POWER   IN   BODY      173 

needed  to  perform  them.  Mind  and  muscular  movement 
have  the  closest  possible  connection  with  each  other. 
The  second  function  of  the  brain  is  that  of  feeling  and 
sensation;  the  third  is  that  of  nutrition;  through  this 
its  own  nourishment  and  that  of  the  rest  of  the  body  is 
regulated.  While  mind  is  the  fourth  and  highest  form 
of  nerve  force,  it  is  not  created  in  the  brain,  but  is  abso- 
lutely conditioned  by  that  organ. 

Different  groups  of  brain-cells  have  different  work  as- 
signed them;  some  have  motion,  some  have  sensation, 
some  have  nutrition,  and  some  have  mind.  For  example, 
special  tracts  of  brain  govern  inhibition.  While  every 
group  does  its  own  work,  it  is  related  to  and  combined 
with  others,  influencing  them,  and  being  influenced  by 
them. 

Every  kind  of  mental  activity  uses  up  the  brain  energy 
of  the  cells.  To  think  clearly,  plenty  of  healthy  blood 
must  be  supplied  to  the  cells.  In  order  to  make  healthy 
blood,  there  must  be  an  abundance  of  fresh  air  supphed 
to  the  lungs,  and  a  vigorous  heart  to  pump  it  up  to  the 
brain.  It  has  been  demonstrated  that,  during  intellectual 
work  or  emotional  feeling,  there  is  an  increased  supply  of 
blood  to  the  brain,  which  may  become  more  or  less  con- 
gested, and  that  there  is  an  actual  rise  of  temperature; 
whereas  during  periods  of  relaxation,  rest,  or  fatigue,  the 
brain  is  pale  and  anemic. 

The  brain-cells  generally,  but  particularly  those  cells 
involved  in  mental  activity,  are  of  such  a  nature  and  con- 
stitution that  they  cannot  rest  absolutely  during  the 
waking  hours.  They  may  act  slowly  or  with  great 
rapidity;  different  brains  have  different  capacities  for 
energizing,  both  in  regard  to  speed  and  force;  and, 
further,  the  brain  may  be  pushed  to  work  greatly  in  excess 
of  its  normal  activity,  just  as  an  engine  may  be  allowed 
to  go  at  the  rate  of  50  or  60  miles  an  hour,  or  may  be 
pushed  to  go  at  the  rate  of  100  miles  an  hour.  In  both 
cases  the  danger  resulting  from  speeding  are  greatly  in 
excess  of  going  at  the  normal  rate  of  speed. 


174  PERSONAL  HYGIENE   FOR  WOMEN 

In  any  case,  the  continuous  brain  action  implies  the 
necessity  for  continuous  repair.  The  only  complete 
physiologic  rest  which  the  brain  enjoys  is  during  sleep, 
when  the  process  of  repair  goes  on  most  rapidly;  during 
this  period  the  brain-cells  absorb  their  nourishment  from 
the  blood  in  excess  of  their  needs,  and  so  lay  up  a  store  of 
energy  for  the  waking  hours. 

Habit  and  Automatism. — It  is  one  of  the  innate 
quahties  of  every  tissue  and  of  eveiy  organ  in  the  body, 
that  when  any  vital  action  is  performed,  any  vital  proc- 
ess gone  through  with,  it  is  easier  to  do  it  the  second  time, 
and  the  continuous  exercise  of  the  action  makes  the  per- 
formances more  and  more  easy,  until  they  become  auto- 
matic. 

The  physiologic  basis  of  habits  consists  of  the  plasticity 
of  the  nerve  substance,  and  in  the  capacity  of  nerve  sub- 
stance to  receive  and  retain  impressions.  There  results 
the  certainty  that  the  nervous  system  wUl  act  again 
more  easily  in  those  ways  in  which  it  has  already  acted. 

On  the  one  hand,  the  automatic  performance  of  work 
saves  an  enormous  amount  of  brain  energy;  on  the  other 
hand,  bad  habits  may  be  formed  whose  effects  may  be 
most  pernicious,  and  which  are  gotten  rid  of  only  with  the 
greatest  difficulty.  An  example  of  the  first  is  the  young 
child  learning  to  walk;  at  first  he  accomplishes  the  feat 
only  by  the  fixed  concentration  of  every  power  of  the 
brain  on  the  act;  whereas  the  healthy  adult  walks 
automatically,  without  paying  the  least  regard  to  the 
movements  or  the  manner  in  which  they  are  accomplished. 
Hysteria  and  ungovernable  outbursts  of  passion  furnish 
good  examples  of  the  bad  habits  that  may  be  fonned, 
owing  to  the  lack  of  discipHne  and  the  powers  of  inhibi- 
tion ;  every  time  that  a  woman  gives  way  to  one  of  these 
outbursts,  so  much  the  harder  will  it  be  for  her  to  prevent 
or  control  another  outbreak.  Inhibition  is  the  highest 
and  most  important  function  of  the  brain. 

Habits  woman  must  have,  but  it  is  for  her  to  choose 
what  they  shall  be,  provided  she  chooses  quickly;    the 


NERVOUS   SYSTEM   BALANCE   OF   POWER   IN   BODY      175 

time  limit  in  habits  is  one  of  the  strong  evidences  of  the 
close  connection  of  body  and  mind.  It  is  a  startHng  fact  to 
face,  that  a  woman's  habits  are  largely  fixed  before  she 
is  twenty;  that  the  chief  lines  of  her  future  growth  and 
acquaintance  before  she  is  twenty-five;  and  her  profes- 
sional habits  before  she  is  thirty;  yet  to  something  Hke 
this  James  believes  that  physiologic  psychology  points. 
The  woman  becomes  a  bundle  of  habits,  and  her  habits 
settle  about  her  Hke  a  plaster  cast. 

The  Physiology  of  the  Brain  and  Nervous  System. — 
The  brain,  spinal  cord,  and  spinal  nerves  constitute  the 
so-called  cerebrospinal  nervous  system.  The  brain  is 
that  portion  of  the  nervous  system  which  is  contained 
within  the  cranial  cavity  and  which  it  completely  fills. 
The  spinal  cord  is  the  continuation  downward,  from  the 
brain  through  the  spinal  canal,  of  nerve  substances,  and 
from  which  the  spinal  nerves  are  given  off.  The  nerves 
may  be  described  as  cords  and  threads  of  varying  degrees 
of  fineness,  distributed  to  every  tissue  and  organ  in  the 
body. 

The  nervous  system  has  been  likened  to  the  electric 
telegraph,  the  brain  being  the  central  station,  while,  in 
addition  to  the  special  senses,  the  body  is  provided  with 
numerous  terminal  substations  in  the  skin  and  internal 
organs  of  the  body,  which  keep  the  brain  informed  of 
what  is  going  on  in  the  world  around  it,  as  well  as  in  the 
various  parts  of  the  body.  The  nerves  simply  act  as 
conductors  to  transmit  the  messages.  The  body  is 
supplied  with  two  distinct  sets  of  nerves  or  wires,  one 
of  which  carries  messages  from  the  outside  world  and 
various  organs  to  the  brain,  while  the  other  set  transmits 
orders  from  the  brain. 

The  spinal  cord  is  the  center  of  reflex  acts;  that  is, 
if  the  leg  of  a  brainless  frog  is  touched  with  acid,  he  wiU 
take  the  other  leg  to  wipe  it  off  with.  There  are,  as 
we  have  seen,  substations  in  the  skin,  hence  the  acid 
causes  the  sensation  of  a  foreign  body,  word  is  telegraphed 
the  spinal  cord,  where  there  is  a  large  central  station; 


176  PERSONAL  HYGIENE   FOR   WOMEN 

from  here  word  is  sent  out  by  another  set  of  nerves,  to 
move  the  leg  away  from  the  acid,  but  this  being  insufficient, 
word  is  telegraphed  to  the  other  leg  to  wipe  off  the  offend- 
ing substance.  Did  the  same  thing  happen  in  the  body, 
at  the  same  time  that  the  cord  telegraphed  word  to  the 
affected  member  to  withdraw  it,  it  would  telegraph  the 
brain,  and  the  sensation  of  pain  would  be  felt. 

A  message  travels  along  a  nerve  at  the  rate  of  about 
thirty-six  yards  a  second,  or  a  mile  a  minute.  This  is 
about  the  time  made  by  a  lightning  express  train.  The 
distance  in  the  body  being  so  short,  the  time  taken  is 
imperceptible,  and  we  say  that  movement  is  instantaneous. 

The  paths  traveled  by  nerve  impulses  are  made  passa- 
ble by  use;  the  oftener  an  impulse  traverses  a  given 
route,  the  more  adapted  such  a  route  becomes  for  future 
trafl&c. 

But  all  of  this  has  to  do  with  the  nerves  which  are 
under  the  control  of  the  will.  There  is  another  set  of 
telegraph  wires  in  the  body,  called  the  sympathetic  or 
vegetative  system,  so-called  because  it  presides  over 
the  processes  of  nutrition  and  is  beyond  the  control  of 
the  will. 

The  Hygiene  of  Work. — Since  the  motor  centers  are 
located  in  the  brain,  it  is  natural  to  expect  that  all  de- 
finitely directed  movements  will  directly  affect  the  brain 
and  the  mental  development,  and  so  it  is.  Du  Bois 
Reymond  says  that  it  is  easy  to  demonstrate  that  such 
bodily  exercises  as  gymnastics,  fencing,  swimming,  riding, 
dancing,  and  skating  are  much  more  exercises  of  the 
central  nervous  system,  of  the  brain,  and  spinal  cord  than 
of  the  muscles. 

It  is  further  urged  that  healthful  energy  of  will  is 
impossible  without  strong  muscles,  which  are  its  organs, 
and  that  endurance,  self-control,  and  great  achievement 
all  depend  on  muscle  habits. 

The  philosophy  of  work  consists  in  its  necessity.  The 
brain-cell  in  health  cannot  cease  to  be  active,  except  to 
a.  partial  extent  during  sleep.    There  must  be  some  output 


NERVOUS  SYSTEM   BALANCE   OF  POWER  IN  BODY      177 

of  mind  from  the  mind  cell  and  of  motor  stimulus  from 
the  motor  cell.  The  proper  selection  of  work  for  that 
particular  brain  to  do,  and  the  physiologic  regulations 
of  the  work  done,  is  the  basis  of  the  hygiene  of  work. 
For  health,  for  happiness,  and  for  efficiency,  right  work 
rightly  done  is  the  most  important  matter  in  any  man's 
or  any  woman's  hfe. 

The  physiologic,  as  well  as  the  moral  necessity,  has 
always  been  conceded  for  every  man  to  have  a  life-work — 
a  vocation;  a  work  for  which  he  should  be  fitted,  and 
for  which  he  was  capable,  sufficiently  congenial  not  to 
sink  into  mere  drudgery,  and  which  would,  at  the  same 
time,  afford  ample  financial  compensation  to  be  remunera- 
tive and  a  stimulus  to  his  power  of  endurance. 

Important,  from  a  physiologic  point  of  view,  as  a 
vocation  is  for  men,  it  is  equally  or  even  more  important 
for  women.  It  is  highly  probable  that  the  unstable 
nervous  system  of  women  and  their  emotional  extrava- 
gance and  dissipations,  whether  of  frivohty,  wickedness, 
or  grief,  is  largely  due  to  lack  of  mental  disciphne  and 
muscular  development.  It  is  a  psychologic  proposition 
that  any  woman  who  has  a  toothache  suffers  less  if  she 
keeps  busy,  and  any  one  will  testify  that  she  suffers  much 
less  from  the  intense  heat  of  summer  if  she  is  busily 
employed. 

One  of  the  great  objects  of  a  definite  and  fixed  occupa- 
tion is  to  turn  the  thoughts  out  from  the  ego.  Work  of 
some  kind  is  indispensable  to  the  health  and  happiness 
of  every  one,  since  it  necessitates  an  objective  instead  of 
a  subjective  attitude  of  mind. 

Experience  teaches  that  the  brain,  like  the  muscles, 
is  subject  to  training;  occasional  excessive  efforts,  with 
long  intervals  of  repose,  are  rather  injurious,  while  a  many- 
sided  activity,  constantly  repeated,  interrupted  by  suffici- 
ent shorter  rests  and  supported  by  sufficient  nutrition, 
is  strengthening.  A  healthy  training  of  the  brain  should 
be  as  many  sided  as  possible. 

Symmetric   development  and  training  of  every  func- 

12 


178  PERSONAL  HYGIENE   FOR  WOMEN 

tion  of  the  brain  is  as  essential  for  mental  efficiency  and 
sanity  as  the  development  of  all  the  muscles  of  the  body 
is  for  bodily  vigor,  and  a  one-sided  training  of  the  mental 
powers  is  as  certain  to  produce  eccentricities  of  habits  of 
thought  and  actions  as  those  occupations  which  call 
into  play  only  the  action  of  certain  groups  of  muscles  is 
to  cause  bodily  deformities.  An3^thing  which  will  prove 
injurious  to  the  dehcate  nerve  substance  must  be  avoided, 
as  laziness,  idleness,  and,  worst  of  all,  any  form  of  nar- 
cotics. 

Many-sided  life  work,  consistently  carried  through,  not 
only  strengthens  the  brain,  but  also  its  continued  power 
of  adaptation,  and  one's  whole  life  is  a  continuous  struggle 
for  adaptation.  The  more  the  brain  works,  the  more 
capable  it  is  of  receiving  new  impressions  and  elaborating 
old  ones,  and  it  retains  its  elasticity  longer. 

Hurry  generally  implies  lack  of  system  in  carrying  out 
the  routine  of  work,  or  the  undertaking  of  more  work 
than  the  individual  can  accompHsh  without  injury  to 
herself.  Few  things  can  more  certainly  muddle  the  brain 
and  produce  a  sense  of  physical  exhaustion  than  a  sense 
of  hurry.  Without  the  sense  of  this  insane  driver  with 
a  lash  in  his  hands  standing  over  one,  she  can  work  more 
rapidly,  with  complete  self-possession,  and  do  more 
accurate  and  better  work.  The  peculiar  sense  of  being 
hurried  has  a  direct  benumbing  physical  effect,  that  can 
often  be  felt  in  the  brain  as  distinctly  confusing. 

The  Toxins  of  Fatigue. — By  speeding  the  machinery 
to  the  utmost,  a  strain  is  placed  on  nerves  and  muscles, 
and  they  are  kept  keyed  up  to  the  greatest  possible  ten- 
sion. There  is  a  natural  pace  that  one  can  keep  up; 
force  the  pace,  and  weariness  results.  A  man  can  go  for 
hours  at  the  rate  of  five  miles  an  hour;  he  can  run  at 
the  rate  of  six  miles  an  hour  for  quite  a  long  while;  but 
if  he  tries  to  run  eight  miles  an  hour,  he  will  drop  out 
very  soon.  The  powers  of  endurance  must  be  gradually 
developed,  but  no  machine  should  ever  be  run  at  its 
utmost  speed. 


NERVOUS   SYSTEM   BALANCE  OF  POWER  IN  BODY      179 

By  undue  pressure,  at  any  period  of  life,  it  is  possible 
to  use  up  energy  that  ought  to  have  been  spread  out  over 
long  periods;  and  this  is  emphatically  the  case  during 
adolescence;  too  heavy  a  drain  is  made  on  futurity, 
which  means  a  serious  breakdown,  or,  at  least,  premature 
old  age. 

It  has  long  been  assumed  that  during  the  activity  of 
muscles  substances  were  produced  which  exerted  a 
poisonous  influence  upon  the  muscle  tissues.  Exactly 
what  these  substances  were  was  not  known,  but  it  was 
supposed  that  they  were  definite  products  of  metabolism 
or  tissue  waste.  It  is  a  well-known  phenomenon,  observed 
during  the  training  of  athletes  and  soldiers,  that  pro- 
longed and  disciplined  exercise  makes  it  possible  for 
individuals  to  support  easily  an  amount  of  work  which 
would  prove  exhausting  or  even  fatal  to  the  untraned. 
Increased  work,  under  any  circumstances,  means  increased 
metabolism,  and  consequently  a  more  rapid  accumulation 
of  its  products. 

A  German  investigator,  Dr.  Weichardt,  has  shown  that 
if  guinea-pigs  were  put  upon  a  miniature  treadmill  and 
forced  to  run  it  until  they  dropped  dead  from  exhaustioti, 
a  highly  poisonous  Hquid  could  be  pressed  from  their 
muscles,  and  that  the  injection  of  this  liquid  or  extract 
into  the  veins  of  healthy  guinea-pigs  produced,  when 
administered  in  small  doses,  rapid  fatigue;  whereas, 
larger  doses  caused  death,  accompanied  by  all  the  symp- 
toms observed  in  the  original  animal  during  the  process 
of  mechanical  tiring. 

On  the  other  hand,  Uquid  taken  from  unworked  guinea- 
pigs  had  no  such  effect.  Further,  that  if  these  Uttle 
animals  were  put  upon  a  treadmill  and  worked  to  just 
short  of  exhaustion,  and  then  were  given  time  to  re- 
cuperate, as  we  say,  the  liquid  or  extract  from  their 
muscles  had  no  such  effect:  it  was  quite  harmless. 

From  the  results  of  these  carefully  carried  out  scientific 
investigations,  Weichardt  has  come  to  the  conclusion 
that  fatigue  is  due  to  a  definite  toxin,  analogous  to  that 


180  PERSONAL  HYGIENE   FOR  WOMEN 

of  diphtheria  and  tetanus,  and  he  beheves  that  the  ex- 
planation of  the  phenomena  of  training  hes  in  the  fact 
that  in  the  body  of  the  athlete  there  must  be  a  specific 
"antibody,"  which  neutralizes  the  "fatigue  toxin"  as 
soon  as  it  is  formed. 

In  the  animals  undergoing  these  experiments  of  extreme 
fatigue  there  was  a  fall  of  temperature.  A  practical  use 
of  this  fact  could  be  made  for  the  individual,  by  noting 
the  fact  that  a  subnormal  temperature  was  a  grave 
danger-signal. 

Other  observers  concede  that  fatigue  is  due  to  chemical 
substances,  produced  in  the  body  as  the  result  of  brain 
and  muscle  activity,  and  find  that  these  toxins  produce 
a  depressing  effect,  especially  on  the  muscular  system, 
and  that  the  sensation  of  fatigue  is  in  large  part  the 
manifestation  of  this  depression.  The  action  of  toxins 
is  not  confined  to  the  tissues  in  which  they  arise;  exces- 
sive activity  of  one  tissue  can  cause  fatigue  of  others. 
The  facts  of  acid  intoxication  are  noticed  as  analogous 
to  fatigue  phenomena,  so  far  as  the  latter  are  due  to 
toxic  substances.  As  antidotes,  only  rest  and  sleep  can 
be  relied  upon. 

Observations  in  the  electric  experiments  on  nerve-cells 
have  shown  a  remarkable  shrinking  of  the  nerve-cells, 
and  especially  of  their  nuclei.  After  five  hours'  con- 
tinuous work,  the  cell  nucleus  was  only  half  its  normal 
size,  and  twenty-four  hours  of  rest  was  necessary  in  order 
to  restore  it  to  its  normal  size,  but  half  that  amount  of 
work  does  not  require  half  that  amount  of  time  for  its 
recovery. 

The  mental  symptoms  of  normal  fatigue  are  loss  of 
memory;  the  sense  of  perception  is  less  acute;  the  associa- 
tion centers  act  less  spontaneously  and  therefore  slower; 
the  vocabulary  diminishes;  the  emotional  tone  is  lowered; 
the  attention  is  unstable  and  flickering.  All  these  are 
marked  symptoms  that  the  individual  is  far  below  her 
best.  All  kinds  of  perceptions  are  more  acute  in  the 
morning. 


NERVOUS  SYSTEM   BALANCE   OF  POWER  IN   BODY      181 

Fatigue  is  not,  therefore,  merely  physically  uncom- 
fortable; it  is  intellectually,  physically,  and  morally 
dangerous. 

Overwork. — A  surplus  nervous  energy  must  be  per- 
sistently aimed  at — what  Emerson  calls  "plus  health." 
It  must  be  indelibly  impressed  on  the  intelhgence  of 
every  one  that  no  fatigued  individual  can  be  at  her  best; 
she  is  doomed  to  do  inferior  work,  to  be  mentally  de- 
pressed, and  to  be  morally  weakened.  Hope  and  courage 
ooze  away,  and  aU  sense  of  proportions  and  perspective 
are  lost. 

The  amount  of  work  that  can  be  performed  without 
fatigue  is  a  matter  of  individuahty,  and  the  only  safe 
gauge  of  overwork  are  the  danger-signals  sent  out  by 
nature — loss  of  appetite,  insomnia,  increasing  exhaustion 
from  day  to  day  without  increase  in  the  amount  of  work 
done,  mental  depression,  lack  of  interest  and  initiative. 
No  one  can  afford  to  disregard  these  danger-signals. 

Habitual  overwork  produces  fag  and  a  desire  for 
stimulants  to  act  as  a  spur  to  the  overworked  muscles 
during  the  day,  and  recourse  to  increased  stimulants  or 
sedatives  to  act  as  hypnotics  at  night.  The  inert  nerve- 
centers  have  no  reserve  energy  to  give  out,  so  it  is  worse 
than  useless  to  stimulate  them.  On  the  other  hand, 
the  nerve-centers  are  at  too  low  an  ebb  to  react  from 
the  depressing  effects  of  sedatives,  which,  to  the  indi- 
vidual, must  be  positively  injurious.  The  aim  must  be 
to  promote  nutrition,  and  to  give  complete  rest  to  the 
exhausted  nerve-centers. 

Brain  work,  to  be  beneficial,  must  be  regulated  with  the 
greatest  care.  During  the  exercise  of  the  brain  there 
is  always  an  increased  blood-supply  to  it.  If  the  exercise 
is  continued  too  long,  there  is  a  tendency  for  the  blood 
to  remain  in  too  great  quantity,  due  to  the  exhaustion 
of  the  nerve-cells,  which  are  no  longer  able  to  control  the 
vessels. 

During  sleep  the  blood-supply  to  the  brain  is  diminished 
and  the  cells  recover  themselves,  but  if  this  hyperemia 


182  PERSONAL  HYGIENE   FOR  WOMEN 

be  persistently  kept  up,  sleep  soon  becomes  impossible, 
the  brain-cells  have  no  opportunity  to  become  repaired, 
and  their  activity  is  diminished. 

Richardson  says:  "  Making  all  allowances  for  differences, 
even  in  the  prime  of  their  mental  and  physical  vigor, 
few  individuals  can  exceed  six,  and  for  most  persons 
prudence  would  direct  not  more  than  four  or  five  hours 
of  close  mental  application,  without  seriously  endanger- 
ing their  health." 

No  real  advantage  is  gained  by  eight  or  ten  hours  of 
daily  study,  since  the  memoiy  and  reasoning  powers 
become  so  exhausted  that  the  assimilation  of  ideas 
becomes  slower  and  more  difficult.  When  in  his  prime, 
Walter  Scott  declared  that  six  hours  a  day  was  all  that 
he  could  profitably  spend  upon  his  Kterary  compositions. 
In  later  years,  because  of  his  pecuniary  embarrassment, 
he  worked  beyond  this  Hmit,  and,  as  the  result  of  exces- 
sive labor,  his  last  years  were  spent  in  hopeless  imbecility. 

Signs  of  Overwork. — These  show  themselves  in 
irritability,  with  a  sense  of  exhaustion,  the  irritability 
being  due  to  an  exhaustion  of  the  nerve-centers.  Work 
becomes  irksome.  There  are  periods  of  depression  and 
melanchoHa,  which  recur  at  shorter  and  shorter  intervals 
and  continue  for  a  longer  period  of  time.  There  is  a  shght 
loss  of  memory,  together  with  inability  to  concentrate 
the  mind  upon  any  given  subject  for  any  considerable 
length  of  time,  and  the  power  of  thought  and  judgment 
are  impaired.  There  are  sleepless  nights,  ringing  in  the 
ears,  fatigue  from  the  slightest  exertion,  an  irregular 
action  of  the  heart,  with  palpitation  and  a  frequent  desire 
to  urinate.    Various  forms  of  pain  and  neuralgia  occur. 

There  may  be  as  yet  no  loss  of  flesh  or  impairment  of 
the  appetite,  but  this  condition  of  cerebral  anemia 
furnishes  the  possessor  with  a  pair  of  blue  spectacles 
through  which  the  intelligence  must  look,  and  which  throw 
their  own  color  over  everything.  Distressing  dreams 
and  unrefreshing  sleep  allow  the  brain  httle  opportunity 
for  either  rest  or  repair.     The  mind  becomes  as  sensitive 


NERVOUS  SYSTEM  BALANCE   OF   POWER   IN  BODY      183 

as  the  skin  after  a  blister,  and  the  calm,  vigorous  mental 
labor  is  superseded  by  feverish  anxiety,  wearing  responsi- 
bility, and  vexing  chagrin. 

When  the  brain  is  well  supplied  with  a  powerful  circula- 
tion, and  a  rich  blood-supply  from  a  good  digestion 
furnishes  it  with  an  abundance  of  pabulum,  the  cares  of 
life  are  borne  with  equanimity  and  cheerfulness.  One 
of  the  most  unerring  signs  of  faihng  health  is  the  inabihty 
to  withstand  the  pressure  of  these  same  daily  cares. 
When  the  cares  that  formerly  sat  lightly  on  the  shoulders 
become  well-nigh  an  insupportable  burden,  a  state  has  been 
reached  where  the  mind  reacts  on  the  body. 

Worry. — It  is  readily  evident  that  worry  is  bred  of 
exhaustion,  and  is  one  of  the  signs  of  overwork;  but,  if 
too  often  indulged  in,  it  becomes  a  fixed  habit,  and  the 
mind  rapidly  becomes  settled  in  a  state  of  gloom. 

It  is  most  important  for  overwrought  business  and 
professional  women,  but  most  especially  for  those  women 
whose  vocations  in  life  combine  three  distinct  occupa- 
tions or  callings — namely,  wives  who  act  in  the  capacity 
of  housekeepers,  ministers  of  finance  to  the  household, 
and  the  bringing  up  of  children — to  reahze  the  importance 
of  not  undertaking  more  than  they  can  accompHsh  with- 
out fret  and  worry.  The  overconscientious  woman  may 
object  that  it  is  selfish  to  consider  her  own  comfort 
when  she  has  work  to  do  for  others,  but  to  expend  too 
freely  of  the  nervous  energy,  even  in  a  good  cause,  is  like 
giving  so  much  of  our  substance  to  charity  that  we  our- 
selves are  in  turn  obhged  to  lean  on  others  for  support. 
In  properly  conserving  our  own  energies,  we  may  ulti- 
mately be  lightening  the  burden  of  others.  There  is  a 
proper  balance  between  the  duty  one  owes  to  one's  self 
and  to  others. 

Once  bred,  worry  is  an  endless  chain.  Tell  such  a 
woman  not  to  worry,  and  she  worries  for  fear  she  may 
worry.  She  is  afraid  that  she  has  decided  wrongly,  and 
regards  decisions  in  regard  to  the  most  trivial  affairs  of 
life  as  though  they  were  matters  of  vital  importance. 


184  PERSONAL  HYGIENE   FOR  WOMEN 

The  obsession  "to  arrive"  is  a  fertile  source  of  fret  and 
worry.  This  habit  of  mind  leads  to  frantic  and  incessant 
labor  and  blocks  all  pleasure  at  every  point.  The  person 
who  plays  a  game  only  to  see  who  wins,  loses  half  of  the 
benefit  of  the  recreation. 

"The  legs  of  the  stork  are  long,  the  legs  of  the  duck 
are  short;  you  cannot  make  the  legs  of  the  stork  short, 
neither  can  you  make  the  legs  of  the  duck  long.  Why 
worry?"    (Chinese  proverb.) 

Insomnia. — This  is  another  symptom  of  overwork. 
The  mind,  worried  and  harassed  all  day,  retires  at  night 
to  struggle  in  the  darkness  and  solitude  with  worries, 
forebodings,  doubts,  and  regrets,  which  now  assume 
gigantic  and  fantastic  shapes.  In  this  case  the  insomnia 
is  due  to  faulty  habits  of  mind. 

Another  form  of  insomnia  is  caused  by  intellectual 
work  being  carried  on  at  night  until  time  for  retiring; 
the  mind  is  then  so  fully  saturated  with  the  subject 
that  it  is  unable  to  throw  it  off  on  going  to  bed. 

Whatever  be  the  cause  of  the  insomnia,  it  soon  becomes 
a  fixed  habit,  and,  whether  it  is  a  case  of  laying  awake  a 
long  time  before  sleep  comes,  or  waking  up  at  a  regular 
hour  toward  morning, — and  it  is  a  curious  fact  that  the 
habit  of  waking  up  recurs  at  almost  precisely  the  same 
hour  in  the  morning, — the  longer  this  habit  of  insomnia 
is  indulged  in,  the  more  difficult  it  is  to  break  it  up. 

Nervousness, — This  is  a  well-known  sign  of  overwork, 
which  shows  itself  in  intense  nervousness  and  irritability. 
Everything  jars  on  the  nerves.  The  woman  gives  way 
to  her  emotions,  over  which  she  loses  control. 

To  keep  placid  when  overworked  to  the  limit  of  physical 
endurance  requires  a  stolidity  of  soul  and  lack  of  nerves 
only  known  to  the  North  American  Indians,  and  perhaps 
the  Japanese,  and  it  matters  not  what  the  kind  of  over- 
work is,  whether  business,  pleasure,  or  charity. 

Nature's  Restoratives. — The  proper  division  of  the 
day  is  eight  hours  to  be  alloted  to  work,  eight  to  sleep, 
and  the  remaining  period  of  eight  hours  is  to  be  divided 


NERVOUS  SYSTEM  BALANCE  OF  POWER   IN  BODY      185 

among  tlie  various  methods  of  refreshing  body  and  mind 
— the  toilet,  eating,  rest,  and  recreations. 

Not  only  are  rest,  recreation,  and  sleep  in  proper 
proportions  essential  to  the  health  of  the  body,  but 
they  are  equally  essential  to  the  quantity  and  the  quality 
of  the  output  of  work.  From  them  result  a  feeling  of 
physical  well-being,  an  exuberance  of  animal  spirits 
which  go  into  the  work.  The  perspective  is  more  ac- 
curate, the  judgment  is  clearer,  and  the  creative  power  is 
greater.  Work  goes  of  itself  with  a  swing.  Happiness 
is  an  expansive  quality,  that  makes  itself  felt  throughout 
the  entire  body,  but  its  effects  are  most  manifest  in  the 
mental  power. 

The  mother  who  so  honestly  works  and  plans  for  the 
good  of  her  family  as  to  give  herself  no  time  to  rest  after 
her  physical  efforts  is  in  such  an  exhausted  condition 
as  only  to  be  able  to  give  them  the  tired  and  critical  side 
of  herself  for  daily  association.  There  are  few  human 
achievements  much  finer  than  to  make  human  beings 
happy,  and  this  power  woman  is  endowed  with  to  a  very- 
large  extent. 

Rest,  to  be  of  value,  must  be  systematically  taken. 
Bearing  in  mind  the  shrinking  in  size  of  the  nerve-cells 
after  stimulation  caused  by  work,  and  that  they  recovered 
their  normal  size  in  relatively  less  time  if  the  shrinkage 
were  less,  it  becomes  obvious  that,  in  order  to  accomplish 
the  best  work,  whether  purely  mental,  or  of  the  more 
complex  mental  and  physical  work  demanded  of  the 
mother  who  is  at  the  same  time  the  housewife,  that  a 
break  in  the  day's  work  will  aid  in  securing  the  best 
results. 

The  exact  time  of  the  daily  siesta  must  be  adapted  to 
the  family  regime,  but  a  fixed  hour  should  be  set  aside 
for  this  purpose,  and  this  should  be  known  as  the  mother's 
hour,  and  nothing  short  of  a  catastrophe  should  be  allowed 
to  infringe  on  it. 

The  woman  should  retire  to  her  bed-room,  undress, 
and  go  to  bed.     The  room  should  be  darkened,  and  at 


186  PERSONAL  HYGIENE   FOR  WOMEN 

the  same  time  there  must  be  an  abundant  supply  of  fresh 
air.  One  soon  forms  the  habit  of  taking  a  short  nap,  of 
perhaps  haK  an  hour;  one  hour  should  be  spent  in  bed. 
After  this,  she  gets  up,  takes  a  shower  or  other  bath, 
dresses,  and  is  then  ready  to  enjoy  hfe  and  be  a  comfort 
to  her  family.  In  this  way  alone  can  absolute  relaxation, 
rest  of  mind,  and  body  be  secured. 

Avocation. — Second  only  to  the  physiologic  necessity 
for  a  vocation  in  life,  is  the  necessity  for  an  avocation, 
and  this  must  be  in  the  nature  of  a  recreation. 

It  is  a  weU-known  fact  in  farming  that  any  one  kind 
of  crop  will  exhaust  the  very  best  soil,  but  few  people 
recognize  the  necessity  for  a  change  of  occupation  and 
recreation  in  order  to  produce  the  best  mental  and 
physical  results. 

Joyless  drudgery  drains  the  springs  of  health.  There  is 
a  mental  starvation,  due  to  the  lack  of  recreation,  as  well 
as  the  physical,  due  to  the  lack  of  bread.  The  French  aris- 
tocrats, noted  for  the  gaiety  of  their  pastimes,  in  spite 
of  their  dietetic  and  other  sins,  furnish  a  remarkable  list 
of  longevity.  Persons  of  a  cheerful  disposition  are 
generally  long-lived,  and  anything  tending  to  counter- 
act the  influence  of  worry  and  discontent  directly  con- 
tributes to  the  preservation  of  the  health.  Despair,  which 
frequently  results  from  years  of  overwork,  can  paralyze 
the  energies  of  vital  functions  like  a  sudden  poison,  while 
hope  fulfilled  has  cured  many  a  disease. 

The  nature  of  the  avocation  chosen  will  necessarily 
depend  upon  the  character  of  the  vocation.  For  women 
whose  vocations  are  intellectual  and  sedentary,  as  writers, 
teachers,  stenographers,  etc.,  some  outdoor  employment, 
which  calls  into  activity  the  muscles  of  the  body,  rests 
the  eyes  and  brain,  and,  at  the  same  time,  pleasantly 
occupies  the  mind,  is  the  best,  as  walking,  gardening, 
lawn-tennis,  goK,  rowing,  etc. 

For  all  women  engaged  in  sedentary  occupations,  daily 
exercise  in  the  open  air  is  the  first  essential,  and  let  them 
be  assured  that  their  feelings  of  fatigue  and  disinclination 


NERVOUS   SYSTEM  BALANCE   OF  POWER   IN  BODY      187 

to  exercise  are  no  safe  guide  as  to  their  ability  to  take 
exercise. 

The  first  cause  of  the  feeling  of  fatigue  is  due  to  the 
lack  of  oxygen  in  the  lungs  and  the  impure  air  of  the 
room.  On  going  out-of-doors,  the  woman  will  be  surprised 
at  how  much  stronger  and  better  she  feels  after  an  hour's 
brisk  walk  than  she  did  on  starting  out. 

''Fancy  work"  and  lace-making,  instead  of  being 
classed  with  recreations,  must  be  classed  with  fine  hand- 
sewing  of  the  most  taxing  kind.  It  calls  the  same  groups 
of  muscles  into  play,  and  is  productive  of  the  same  evils, 
with  a  greater  tendency  to  produce  eye-strain  and  a 
paralysis  similar  to  writer's  cramp. 

The  proper  avocation  of  the  tired  housewife,  who  has 
been  on  her  feet  all  the  time  and  whose  vocation  is  manual 
labor,  will  be  the  diversion  of  the  mind  by  reading  a 
good  book,  while  comfortably  pillowed  on  a  veranda 
chair,  a  drive,  a  visit  to  some  congenial  friend,  a  game  of 
cards,  or  music. 

Literary  clubs  for  women  should  be  more  largely  organ- 
ized through  the  country  and  in  country  towns.  In  the 
cities  women  have  found  these  clubs  a  great  boon,  not 
only  to  the  health  and  happiness,  but  they  are  in  the 
highest  degree  educational. 

Further,  women  have  found  that  these  Hterary  clubs 
were  profitable,  as  a  means  of  bringing  their  minds  in 
contact  with  other  educated  minds,  and  thus  they  had 
not  only  the  additional  stimulus  to  study,  but  a  broaden- 
ing of  their  horizon,  which  the  woman's  heretofore  shut- 
in  household  Hfe  had  precluded.  Courses  in  domestic 
science  would  be  a  boon  to  the  home. 

The  greater  the  number  of  interests  which  education 
and  culture  have  created,  the  greater  wiU  be  the  diversity 
of  the  recreations  open  for  the  woman's  enjoyment. 

Care  must  be  taken  that  the  avocation,  which  is  at  first 
an  enjoyment  and  relaxation,  is  not  turned  into  hard 
labor.     The  moment  that  any  one  strains  every  nerve, 


188  PERSONAL  HYGIENE  FOR  WOMEN 

even  to  excel  in  a  game,  that  moment  it  ceases  to  be  a 
relaxation. 

History  shows  that  the  laws  of  all  nations  have  always 
provided  a  certain  number  of  days  of  rest,  or  at  least  a 
change  of  occupation,  and  that  these  days  were  fixed  at 
more  or  less  regular  intervals.  This  was  partly  from  a 
religious  and  partly  from  a  hygienic  standpoint.  The 
necessity  for  the  interruption  of  the  regular  routine  work 
has  always  been  recognized,  and  one  day  out  of  every 
seven  has  been  set  aside  for  this  purpose. 

The  custom  that  is  so  frequently  adopted  by  city  folk 
of  going  out  of  town  over  Sunday  might  very  well  be 
imitated  by  country  folk  by  going  into  the  town  or  city 
over  Sunday.  For  not  only  is  the  too  continuous  apphca- 
tion  to  one's  employment  fraught  with  danger,  but  it 
has  been  conclusively  shown  that  a  monotonous  routine 
of  occupation,  such  as  lived  by  the  average  farmer's  wife, 
is  a  severe  tax  on  the  sanity  of  the  mind.  Statistics  show 
that  the  heaviest  percentage  of  insanity  faUs  on  farmer's 
wives,  and  the  supposed  cause  of  this  is  the  monotony  of 
their  Hves. 

A  horse  cannot  gaUop  as  many  hours  as  it  can  walk, 
and  the  daily  task  should  be  the  sum-total  of  what  man 
or  beast  can  do  compatibly  with  health.  To  combine 
a  day  of  toil  with  a  second  of  amusement  in  one  twenty- 
four  hours  does  not  give  the  proper  allowance  for  sleep, 
and  cannot  be  done  without  injury  to  the  individual. 

Fun  and  laughter  are  the  most  efficacious  remedies  in 
the  pharmacopeia,  and  tired  humanity  owes  a  debt  of 
gratitude  to  the  guild  of  humorists,  be  they  writers, 
comedians,  or  musical  composers. 

The  Physiologic  Necessity  for  Laughter. — The  at- 
titude of  the  individual  varies  with  age,  temperament, 
and  the  perspective  of  Hfe.  Grave  adults  are  apt  to  think 
of  laughter  and  smiling  as  something  occasional,  a  momen- 
tary lapse  once  in  a  while  from  the  persistent  attitude  of 
seriousness.  Healthy  children,  on  the  contrary,  consider 
that  a  state  of  laughter  is  the  normal  condition  of  human- 


NERVOUS   SYSTEM  BALANCE  OF   POWER  IN   BODY      189 

ity,  and  that  seriousness  is  a  tiresome  necessity,  which 
must  be  tolerated  from  time  to  time.  But  very  few  people 
have  any  idea  that  there  exists  a  well-defined  physiologic 
necessity  for  laughter,  and  the  greater  the  intellectual  labor 
and  the  mental  strain,  the  greater  is  this  necessity. 

The  deep  forcible  chest  movements  increase  the  rapidity 
of  the  circulation,  the  force  of  the  heart's  beat,  and  secures 
a  more  complete  oxygenation  of  the  blood. 

It  is  not  improbable  that  this  accelerated  circulation 
produces  remote  effects  on  the  organism.  One  of  the  im- 
mediate effects  of  a  good  laugh  is  that  it  relieves  the  brain 
by  the  rapidity  of  the  movements  of  the  blood  through 
the  capillary  circulation. 

In  addition  to  the  immediate  physiologic  effects  which 
result  from  laughter  it  is  highly  beneficial,  by  relieving 
the  brain  and  nervous  system  from  the  intense  strain 
and  tension  of  the  daily  affairs  and  occupations  of  life, 
and  gives  relief  to  the  severely  congested  capillaries,  which 
otherwise  involve  considerable  risk  to  the  individual. 

Physiologists  hold  that  pleasurable  feelings  tend  to 
further  the  whole  group  of  organic  functions,  and  that 
laughter  produces  a  considerable  increase  of  vital  activity 
by  the  heightened  nervous  stimulation.  There  is  a  sense 
of  increased  energy,  of  a  high  tide  of  the  fulness  of  the  life 
current. 

Vacations  and  Health. — The  secret  of  success  of  the 
old  Romans  in  conquering  the  world  lay  as  much  in  their 
ability  to  maintain  the  health  of  their  troops  in  their  va- 
rious campaigns  as  by  the  courage  and  organization  of 
those  troops;  or,  rather  it  may  be  said  that  courage  is 
but  the  coefficient  of  a  good  physique  and  a  general  men- 
tal vigor. 

A  rest  one  day  out  of  seven,  with  an  occasional  outing 
for  the  week-end,  is  good  but  not  sufficient.  If  one  would 
keep  up  to  her  highest  standard  of  physical  and  mental 
efficiency,  she  must  have  at  least  one  month  of  absolute 
change  of  environment  and  outdoor  life  in  the  year. 

The  kind  of  place  one  choses  for  her  vacation  will 


190  PERSONAL  HYGIENE  FOR  WOMEN 

depend  on  where  her  home  is.  To  dwellers  in  cities,  the 
mountains  and  seaside  resorts  are  the  most  beneficial, 
August  is  our  most  trying  month,  and  every  one  who  can 
would  do  well  to  take  her  vacation  at  that  time,  always 
selecting  some  resort  north  of  her  own  home,  so  that  she 
may  have  the  additional  advantage  of  a  more  bracing 
climate. 

Maine  furnishes  many  of  the  most  beneficial  of  our 
health  resorts,  combining  as  it  does  so  many  attractions — 
its  bracing  atmosphere  of  pine  forests,  its  beautiful 
scenery  with  vast  expanses  of  water,  and  the  great  variety 
of  diversions  which  it  affords. 

It  is  always  wise  to  send  an  advance  scout  to  investigate 
the  place  in  which  you  contemplate  spending  your  vaca- 
tion. Avoid  low  and  swampy  land;  investigate  the 
character  of  the  water-supply  and  the  nature  of  the 
plumbing,  together  with  the  sewerage  system,  for  it  is 
all  too  frequent  that  an  attack  of  typhoid  fever  follows 
an  outing  in  the  country.  Every  good  summer  resort 
should  furnish  facifities  for  a  variety  of  outdoor  sports — 
golf,  tennis,  boating,  swimming,  etc. 

During  the  vacation  needless  exposure  to  the  direct 
rays  of  the  sun  must  be  avoided.  There  is  probably 
nothing  which  lowers  the  vital  resistance,  and  so  prepares 
the  way  for  disease  as  much  as  exhausting  exposure  to  the 
hot  rays  of  the  sun. 

Long  hours  of  sleep  should  be  indulged  in.  The  morn- 
ing air  is  the  most  beneficial;  it  is,  therefore,  a  good  habit  to 
retire  early  and  to  rise  early. 

If  the  vacation  is  not  properly  spent,  it  may  be  the 
means  of  doing  more  harm  than  good.  On  the  other 
hand,  if  properly  spent,  vacations  prepare  one  as  nothing 
else  can  to  meet  and  resist  the  vicissitudes  of  the  follow- 
ing winter.  It  is  the  people  who  go  off  on  long  vacations 
who  have  the  least  need  of  the  doctor's  care. 

Sleep. — During  sleep  all  the  bodily  functions  are  in 
abeyance  and  the  secretions  are  diminished;  respiration 
is  slow  and  confined  to  the  chest,  so  that  the  amount  of 


NERVOUS   SYSTEM   BALANCE   OF  POWER  IN   BODY      191 

inspired  air  is  only  one-seventh  of  that  during  the  waking 
hours;  the  temperature  of  the  body  falls;  less  blood 
circulates  through  the  brain;  and  the  sensibility  of  the 
nerves  to  external  stimuli  is  diminished.  Sleep  is  not 
only  'par  excellence  the  time  of  repose  and  recuperation 
of  the  brain  and  nerve  substance,  but  it  is  the  only  time 
when,  by  the  diminution  of  waste  caused  by  the  incessant 
activity  of  the  brain,  that  the  organ  can  be  properly 
nourished,  the  deficit  in  nerve  force  canceled,  and  the 
surplus  of  energy  stored  up. 

Without  this  absolute  remission  of  brain  activity  every 
twenty-four  hours  an  actual  destruction  of  substance 
would  occur,  which,  if  persisted  in,  would  be  so  depressing 
to  the  nervous  functions  as  to  be  inconsistent  with  Hfe, 
and  this  is  the  case  in  the  concluding  stages  of  fatal 
diseases. 

The  sleepy  feeHng  caused  by  fatigue  is  due  to  the 
circulation  in  the  blood  of  toxins  resulting  from  tissue 
waste,  which  benumb  the  brain-cells;  while  the  feehng 
of  freshness  and  bien-etre  with  which  one  awakens  in  the 
morning  is  due  to  the  eHmination  of  the  fatigue  products 
from  the  blood  during  sleep.  If  the  blood  of  a  tired 
dog  be  transfused  into  the  veins  of  a  perfectly  fresh  animal, 
the  latter  will  immediately  show  symptoms  of  somnolence 
and  seek  a  dark  comer  for  sleep. 

The  medical  authorities  of  to-day  are  pretty  well  agreed 
that  eight  hours  of  sleep  is  the  minimum  required  for  the 
maintenance  of  health,  and  all  concede  that  the  brain- 
worker  requires  more  sleep  than  the  manual  laborer. 
Every  moment  after  the  feehng  of  languor  presents  itself 
is  a  strain  upon  the  nerves  and  muscles  which  will  sooner 
or  later  invalidate  for  life,  and  finally  bring  the  victim 
to  a  premature  grave.  Habitual  deficiency  of  sleep  will 
undermine  the  strongest  constitution. 

It  is  a  matter  of  great  importance  to  train  one's  self 
in  the  habits  of  sleep,  regularity  in  the  hour  of  retiring, 
abstinence  from  active  brain  work  for  the  hour  immediately 
preceding  going  to  bed,  since,  if  active  brain  work  is  con- 


192  PERSONAL  HYGIENE   FOR  WOMEN 

tinued  until  one  goes  to  her  room  for  the  night,  the  chances 
are  that  the  brain  will  continue  its  activities  after  getting 
into  bed,  and  sleep  may  be  banished  from  the  pillow 
for  several  hours. 

A  few  minutes  spent  in  breathing  exercises,  the  vigorous 
use  of  the  flesh  brush  or  hair  glove,  a  hot  plunge  or  foot- 
bath are  no  mean  hypnotics. 

A  sound  sleep  is  dreamless.  Dreams  require  a  certain 
expenditure  of  nerve  force  and  mental  energy,  so  that 
dreamless  sleep  is  the  most  restful.  Disagreeable  dreams 
and  ''night-mares"  are  generally  associated  with  indiges- 
tion and  biliousness,  which  also  occasion  a  general  rest- 
lessness. All  this  can  be  overcome  by  taking  some  med- 
icine for  the  liver.  Two  grains  of  calomel  taken  just 
before  retiring  often  works  like  a  charm.  The  dose  must 
not  be  repeated  under  a  month.  In  case  of  tendency  to 
insomnia,  no  coffee  should  be  taken  after  breakfast. 

Treatment  of  Insomnia. — The  mechanical  measures 
for  the  relief  of  insomnia  have  for  their  purpose  the  with- 
drawing of  the  blood  from  the  brain  to  the  surface  of  the 
skin.  Hot  foot-baths;  general  warm  baths ;  cold  douches 
to  the  spine,  brisk  exercise;  Hght  massage,  and  cold  rooms. 
Mental  work  should  be  laid  aside  several  hours  before 
retiring;  late  suppers  avoided;  coffee,  if  taken  at  all, 
should  only  be  taken  for  breakfast,  and  then  only  one 
cup.  Reading  or  amusement  should  be  selected  that 
does  not  excite  the  nerves. 

To  woo  sleep  the  woman  should  put  herself  in  a  position 
of  rest,  which  of  itself  physiologically  induces  sleep. 
Avoid  irritations,  noises,  bad  air,  cold  feet,  overloaded 
bowels,  all  of  which  tend  to  wakefulness  and  to  prevent 
the  proper  physical  rest.  Then  sleep  usually  comes  of 
itself. 

The  Eyes :  Eye-strain. — Of  all  the  misfortunes  that 
could  befall  a  human  being,  the  loss  of  sight  is  probably 
the  greatest,  and  yet  no  organ  of  the  body  is  so  constantly 
abused  as  the  eye. 

The  trouble  is  that  the  possessor  of  the  normal  eye 


NERVOUS  SYSTEM  BALANCE  OF  POWER   IN  BODY      193 

does  not  take  into  consideration  that  in  all  near  work,  as 
in  reading,  writing,  sewing,  etc.,  the  eye  is  actively- 
engaged  as  well  as  the  hands  and  brain,  and  that  the  eye 
only  is  at  rest  when  looking  into  space  or  when  closed. 

Description  of  the  Visual  Apparatus. — The  eyeball 
is  contained  and  protected  in  a  bony  cavity,  formed  by 
the  bones  of  the  face  and  skull,  and  is  supported  by  a 
cushion  of  fat  and  other  tissues.  It  is  held  in  place  by 
its  membranes  and  muscles,  by  which  it  is  also  moved. 
It  is  further  protected  by  the  eyehds,  the  eyebrows,  and 
the  eyelashes.  The  eyebrows  protect  the  eyes  from 
dust  and  perspiration  and  shade  the  eyes. 

The  eyelids  are  lined  by  a  very  delicate  mucous  mem- 
brane, called  the  conjunctiva.  They  are  maintained  in 
close  apposition  to  the  eyeball  by  atmospheric  pressure. 
The  tears  are  secreted  by  the  lacrimal  gland,  which  is 
at  the  upper  and  outer  angle  of  the  orbit.  The  lubrica- 
tion by  the  tears  and  the  mucus  secreted  by  the  con- 
junctiva cause  them  to  move  smoothly  and  without  fric- 
tion. An  important  function  of  the  hds  is  to  distribute 
the  tears  over  the  front  of  the  eyeball,  and  by  incessant 
winking  to  free  the  front  of  the  eye  from  dust  and  to  keep 
it  moist. 

The  conjunctiva  is  continuous  with  the  mucous  mem- 
brane of  the  nose  and  mouth.  Hence,  in  inflammation 
of  the  nasal  mucous  membrane,  as  in  an  ordinary  cold  in 
the  head  or  influenza,  the  conjunctiva  is  liable  to  become 
very  much  congested  or  inflamed. 

The  eyeball  is  spherical  in  form,  having  the  segment  of 
a  smaller  and  much  more  prominent  sphere  ingrafted  on 
its  anterior  part.  The  segment  of  the  larger  sphere,  which 
forms  about  five-sixths  of  the  globe,  is  opaque,  and  forms 
the  sclerotic  coat,  the  so-called  "white"  of  the  eye.  The 
smaller  sphere,  which  forms  the  remaining  sixth,  is  trans- 
parent, and  is  formed  by  the  cornea. 

The  iris  is  a  circular  contracting  membrane,  suspended 
from  the  edges  of  the  cornea,  in  front  of  the  eye  like  a 
curtain.     The  iris  gives  color  to  the  eye,  and  when  we 

13," 


194  PERSONAL  HYGIENE   FOR  WOMEN 

say  that  an  eye  is  blue  or  brown,  we  mean  that  is  the  color 
of  the  iris.  The  iris  is  freely  movable,  and,  according  as 
to  whether  it  dilates  or  contracts,  there  is  an  alteration 
in  the  size  of  the  central  aperture,  called  the  pupil. 

The  chief  function  of  the  iris  is  to  regulate  the  quantity 
of  light  admitted  to  the  interior  of  the  eye.  In  a  very  strong 
light  the  pupil  quickly  contracts,  shutting  out  the  exces- 
sive light,  while  in  a  subdued  Hght  the  pupil  dilates,  thus 
allowing  more  light  to  enter.  When  looking  at  a  distance 
or  when  looking  languidly  into  space,  the  pupil  dilates. 

The  Formation  of  the  Image. — The  eye  is  a  camera,  con- 
sisting of  a  series  of  lenses  and  media  arranged  in  a  dark 
chamber,  the  iris  serving  as  a  curtain.  The  object  of  the 
apparatus  is  to  form  on  the  retina  a  distinct  image  of 
external  objects. 

The  Mechanism  of  AccomTmdation. — In  the  passive 
condition  of  the  eye,  when  it  is  adjusted  for  far  objects, 
the  anterior  surface  of  the  lens  is  somewhat  flattened. 
Accommodation  for  near  objects  consists  in  a  contraction 
of  the  circular  ciliary  muscle  and  an  increase  in  the  con- 
vexity of  the  anterior  surface  of  the  crystalline  lens. 

The  light  enters  the  eyeball  through  the  pupil,  falls 
upon  the  retina,  which  has  often  been  compared  to  the 
sensitive  plate  of  a  camera,  is  received  and  transmitted 
by  the  optic  nerve  to  the  visual  centers  of  the  brain. 
The  eyeball  does  not  see.  It  is  only  a  sensitive  end-organ, 
which  receives  and  transmits  the  impressions  to  the 
higher  centers  of  sight.  The  act  of  vision  is  performed 
in  the  brain. 

The  focusing  power  of  the  eye  is  the  property  of  bend- 
ing nearly  parallel  rays  of  light  from  distant  and  divergent 
rays  or  from  close  range  so  that  they  meet  exactly  on  the 
sensitive  retina;  this  is  called  refraction.  In  the  normal 
eye  these  rays  are  focused  exactly  on  the  retina. 

Optical  Defects  and  their  Correction. — In  the  normal 
eye  the  near  limit  of  accommodation  is  from  4  to  5  inches, 
and  the  far  limit  may  be  put  at  an  infinite  distance. 

Myopia  or  Near-sightedness. — This  is  one  of  the  most 


NERVOUS  SYSTEM   BALANCE   OP   POWER   IN   BODY      195 

common  refractive  defects  of  the  eye.  In  this  condition, 
because  of  the  greater  length  of  the  eyeball  or  increased 
refractive  changes  of  the  media,  rays  of  light  from  a 
distance  are  focused  in  front  of  the  retina,  producing  an 
indistinct  image. 

The  near-point  is  brought  much  nearer — from  2  to  2^ 
inches — and  the  far  limit  is  at  a  very  short  distance. 

In  reading,  the  myope  is  obliged  to  hold  her  book  very- 
close  to  the  eyes  in  order  to  see.  In  doing  so,  she  strains 
her  muscles  of  convergence,  producing  ocular  congestion 
and  compression  of  the  eyeball. 

The  predisposing  causes  of  myopia  are  heredity;  it  is 
said  that  half  of  myopics  are  descended  from  near- 
sighted parents;  uncorrected  astigmatism,  and  the  effort 
to  read  very  fine  print  or  figures,  entails  severe  strain  on 
the  eyes,  which  may  result  in  myopia. 

Myopia  is  corrected  by  a  concave  lens,  which  diverges 
the  rays  of  Hght,  prolonging  the  focal  distance,  so  that 
the  rays  of  light  are  focused  exactly  on  the  retina. 

Not  only  are  myopic  eyes  not  injured  by  wearing  suit- 
able glasses,  but,  on  the  contrary,  are  often  preserved 
from  injurious  pressure  on  the  globe,  due  to  the  indul- 
gence of  the  habit  to  nearly  close  the  Hds  in  order  to  see 
better,  as  is  commonly  done  when  glasses  are  not  worn. 

Hyperopia  or  Far-sightedness. — In  this  condition  the  eye- 
ball is  too  short,  and  the  rays  of  hght  from  a  distance 
are  focused  behind  the  retina.  Instead  of  being  distinct, 
the  image  is  blurred.  Hyperopia  is  corrected  by  a  convex 
lens,  which  converges  the  rays  of  light,  bringing  them 
sooner  to  a  focus.  In  the  hyperopic  eye  the  near-point 
of  accommodation  is  at  some  distance,  and  a  far  limit  of 
accommodation  practically  does  not  exist. 

Presbyopia. — This  is  a  loss  of  the  power  of  accom- 
modation, by  which  reading,  writing,  sewing,  and  other 
near  work  is  accomplished.  This  power  of  accommoda- 
tion is  greatest  in  early  life,  and  gradually  diminishes 
until  about  the  age  of  forty  years,  when  reading  at  the 
ordinary    distance    becomes    uncomfortable.     At    about 


196 


PERSONAL  HYGIENE  FOR  WOMEN 


seventy-five  years  of  age  the  power  of  accommodation 
is  practically  lost. 

Every  person  over  forty-five  years,  with  normal  or  far- 
sighted  eyes,  should  wear  glasses  to  perform  near  work. 

Astigmatism. — Astigmatism  does  not  depend  on  the 
length  of  the  eyeball,  but  on  the  curvature  of  the  cornea, 
and  rarely  on  that  of  the  lens.  Uncorrected  astigmatism 
necessitates  the  expenditure  of  more  muscular  effort  in 
the  attempt  to  see  distinctly  than  is  necessary  when 


Fig.  12. — Astigmatic  chart. 


refraction  is  normal.  This  is  accompanied  by  early 
fatigue  and  more  or  less  congestion  of  the  vascular  tunics 
of  the  eye.  Astigmatism  is  corrected  by  a  cylindric  lens, 
which  has  a  plane  surface  in  one  axis  and  a  concave 
surface  in  the  axis  at  right  angles  to  it. 

In  simple  astigmatism,  on  looking  at  the  accompany- 
ing astigmatic  chart  with  each  eye  separately,  certain  lines 
in  the  defective  meridian  seem  very  much  blurred,  while 
those  at  exact  right  angles  appear  clear  and  black.     This 


NERVOUS  SYSTEM  BALANCE   OF  POWER  IN  BODY      197 

furnishes  a  test  for  astigmatism,  since  to  the  normal  eye 
the  lines  appear  of  equal  distinctness  and  clearness. 
Astigmatism  is  a  very  common  ocular  defect. 

The  Mechanism  of  Eye-strain. — Comparatively  few 
eyes  are  perfect.  Far-sighted  or  astigmatic  eyes  can 
secure  perfect  vision  by  means  of  accommodation.  By 
constant  strain  on  the  ciliary  muscle,  the  crystalline  lens 
is  so  increased  in  curvature  as  to  exactly  counterbalance 
the  optical  defect  of  the  eyes. 

Healthy  eyes  should  do  their  work  without  the  con- 
sciousness of  the  owner,  and  this  is  a  safe  test  as  to  the 
kind  and  amount  of  work  demanded  of  them. 

Perfect  rest  for  the  eyes  is  impossible  in  the  waking 
state — distant  vision  represents  rest  for  the  eyes  and  near 
vision  exertion. 

Near  work  is  the  chief  cause  of  near-sightedness. 
Distant  vision  should  alternate  with  near  work,  and  in 
near  work  the  object  should  not  be  brought  nearer  to  the 
eyes  than  12  inches. 

The  Local  Symptoms  of  Eye-strain. — There  may  be 
a  sense  of  fatigue  in  the  eyes  after  reading  for  a  short 
time,  and  this  may  be  followed  by  a  constant  sense  of 
discomfort  in  the  eyes,  which  is  increased  on  using  them, 
and  which  may  be  accompanied  by  severe  pain  in  the 
back  of  the  head.  There  is  a  sensitiveness  to  light,  and 
inflammation  of  the  eyelids  and  conjunctiva.  There  may 
be  twitching  of  the  eyelids,  and  in  extreme  cases  difficulty 
in  keeping  the  eyes  open  on  account  of  drowsiness.  The 
eyes  may  smart,  itch,  or  burn,  and  continually  "water." 

As  the  trouble  becomes  more  pronounced,  reading 
for  a  short  time  may  be  followed  by  a  blurring  of  the 
type,  and  finally  the  fines  may  run  together.  There  is 
a  constant  sense  of  the  eyes  feeling  for  the  lines,  and, 
perhaps  one  of  the  first  things  to  call  attention  to  the 
condition  of  the  eyes  may  be  the  losing  of  the  fines  in 
reading. 

The  general  or  reflex  symptom  of  eye-strain  is  head- 
ache, which  frequently  takes  the  form  of  migraine.    This 


198  PERSONAL  HYGIENE  FOR  WOMEN 

is  increased  on  reading,  sewing,  riding  in  the  cars,  etc. 
The  headache  is  usually  over  the  region  of  the  temples 
or  just  above  the  eyes,  but  it  may  be  on  the  top  of  the 
head  or  at  the  base  of  the  skull. 

Vision  is  so  fundamentally  related  to  all  the  brain  func- 
tions that  eye-strain,  or  anything  which  interferes  with 
normal  sight,  may  cause  the  most  varied  disturbances 
of  bodily  functions. 

The  Prevention  of  Eye-strain. — Persons  whose  work 
necessitates  much  ocular  labor  should  vary  their  duties 
with  intervals  of  rest.  In  continued  reading  or  sewing 
it  is  well  to  desist  at  short  intervals  and  fix  the  gaze  on  some 
distant  object,  and  to  frequently  close  the  lids. 

Lace  work,  very  fine  needle  work,  working  on  black 
goods,  reading  very  fine  print,  or  print  on  an  inferior 
quality  of  paper,  or  attempting  to  read  in  a  dim  light,  are 
all  a  severe  tax  on  the  eyes,  and  should  be  avoided, 
as  they  are  certain  to  cause  them  permanent  injury. 

Defective  vision  is  so  common  in  school-children,  it  is 
so  often  present  without  being  suspected,  and  so  much 
harm  is  done  to  the  eyes  and  the  general  health  of  the 
individual  before  it  is  discovered,  that  there  should  be 
a  compulsory  law  requiring  the  examination  of  all  school- 
children; and,  again,  before  boys  and  girls  enter  the 
normal  schools  and  colleges. 

Clear  vision  gives  clear  judgment;  defective  vision  in  its 
various  manifestations  gives  different  warps  and  bents 
to  the  mind  of  their  unfortunate  possessors. 

Veils. — The  wearing  of  veils  is  responsible  for  not  a 
little  deterioration  of  vision,  particularly  when  they  are 
thick  or  dotted.  Unless  the  meshes  of  the  veil  are  very 
large,  it  holds  a  layer  of  impure  air  close  to  the  face,  so 
that  the  wearer  is  breathing  vitiated  air.  It  hinders 
clearness  of  vision,  because  the  external  world  is  viewed 
through  a  narrow  lattice. 

The  best  veil  for  the  eyes  is  one  with  a  single  mesh, 
either  without  dots,  or  the  dots  so  far  apart  that  none 
shall  come  over  the  eyes. 


NERVOUS   SYSTEM  BALANCE   OP  POWER   IN   BODY      199 

Protection  of  the  Eyes  from  the  Glare  of  the  Sun. — In  very 
hot  weather  the  eyes  should  always  be  so  protected  that 
the  rays  of  the  sun  do  not  shine  directly  into  them.  This 
protection  may  be  afforded  by  the  brim  of  the  hat  or  by  a 
parasol.  At  the  sea-shore,  or  on  an  ocean  voyage,  where 
the  glare  of  the  sun  is  constant  and  particularly  trying, 
the  eyes  should  be  protected  by  wearing  slightly  tinted 
smoked  glasses. 

Artificial  Lighting. — The  main  sources  of  artificial 
lighting  are  kerosene,  gas,  and  electricity.  The  principal 
questions  of  importance  are  the  quantity  and  quality  of 
the  hght,  its  steadiness,  the  vitiation  of  the  atmosphere 
by  the  products  of  combustion,  and  the  expense;  also  the 
proper  arrangement  of  the  fight. 

Kerosene  is  the  most  extensively  used  means  for  arti- 
ficial fighting.  The  principal  objections  are — the  heat, 
the  trouble  of  filfing  and  keeping  the  lamps  in  order,  and 
the  danger  of  explosion  and  fire  if  upset;  the  odor  and 
the  great  vitiation  of  the  atmosphere. 

The  modem  lamp  gives  a  brilliant  Hght,  and  if  prop- 
erly shaded  by  a  sfightly  bluish  chimney,  so  as  to  absorb 
the  excess  of  yellow  rays,  it  is  very  satisfactory. 

IHuminating  gas,  as  furnished  in  cities,  has  a  great 
excess  of  yefiow  rays,  which  are  very  injurious  to  the  eyes, 
and  the  vitiation  of  the  atmosphere  is  very  considerable. 
Gas-fight  is  modified  by  the  Argand  and  Bimsen  burners. 
Of  these,  the  Bunsen  burner,  a  patented  composition 
burner,  heated  to  incandescence,  is  the  best.  It  gives  a 
white  fight,  resembfing  dayfight,  and,  under  proper  adjust- 
ment, a  far  greater  volume  than  any  other  burner.  It  is 
not  so  hot,  does  not  consume  as  much  gas,  and  so  there  is 
less  vitiation  of  the  atmosphere.  It  is  intensely  briUiant, 
and  must  be  shaded  by  ground  glass  or  a  proper  shade. 

Electricity  gives  the  very  best  fight,  with  a  minimum 
amount  of  heat  and  vitiation  of  the  atmosphere.  For 
individual  use  16-candle  power  is  sufficient. 

The  lamp-shade  should  be  opaque,  of  a  dark-green  color, 
and  lined  with  a  white,  reflecting  surface.     Transparent 


200  PEKSONAL  HYGIENE   FOE  WOMEN 

lamp-shades,  especially  when  patterned,  are  always  bad, 
whatever  their  color;  because  of  the  different  degree  of 
illumination  thrown  upon  the  work,  the  Hght  is  irritating 
to  the  eyes. 

Hygienic  Precautions  in  Reading  and  Sewing. — 
There  should  be  free  access  of  open  dayhght.  Near  the 
window  is  obviously  the  best  place  for  working,  and  the 
seat  should  be  so  selected  that  the  window  is  to  the  left  of 
the  worker.  This  prevents  the  work  from  being  shaded 
by  the  hand,  and  protects  the  eyes  from  being  fatigued 
by  the  light  falling  directly  into  them. 

Any  room  will  have  too  much  Hght  into  which  the  sun 
shines  directly.  Even  if  the  worker's  face  is  not  turned 
directly  toward  the  sun,  yet  the  Hght  reflected  from  the 
book  or  other  work  wiU  be  so  intense  as  to  be  dazzHng. 
The  softest  and  most  pleasant  Hght  to  work  by  is  the 
diffused  light  from  the  northern  sky.  An  excess  of 
Hght  may  be  easily  regulated  by  a  shade. 

Reading. — 'Very  fine  type  should  always  be  avoided, 
it  is  a  very  unnecessary  strain  on  the  eyes,  as  are  also 
books  printed  on  a  poor  quality  of  paper  with  improper 
spacing.     The  paper  should  be  unglazed. 

Length  of  Line. — The  length  of  the  printed  Hne  should 
not  be  more  than  4  inches,  nor  less  than  2f  inches;  that 
is,  not  more  than  10  or  less  than  7  centimeters.  If  the 
line  is  too  long,  the  effort  to  find  the  succeeding  Hne  is 
too  great.  If,  on  the  other  hand,  the  line  is  too  short, 
the  lateral  movements  of  the  eye  are  so  frequent  that  the 
muscles  concerned  in  these  movements  soon  become 
fatigued. 

The  position  of  the  reader  should  be  sitting  upright, 
with  the  back  toward  the  Hght,  which  should  fafl  over  the 
left  shoulder,  and  the  book  held  nearly  on  a  level  with 
the  eyes.  The  book  should  be  held  at  a  distance  of  about 
12  inches  from  the  eyes.  The  Hght  should  be  on  a  level 
with  the  head  or  slightly  above  it.  In  desk  work,  a  shade 
should  always  be  worn  to  protect  the  eyes. 

Reading  in  the  recumbent  position  is  a  pernicious  habit, 


NERVOUS  SYSTEM  BALANCE   OF  POWER   IN  BODY      201 

and  is  particularly  bad  when  convalescing  from  an  illness 
or  when  very  tired. 

Reading  in  carriages  or  cars  is  injurious  to  all  eyes, 
but  especially  so  to  myopic  eyes;  because  of  the  constant 
jolting,  the  distance  between  the  type  and  the  eyes  is 
continually  changing,  necessitating  the  frequent  and 
abrupt  adjustments  of  accommodation;  besides,  the 
illumination  is  apt  to  be  very  poor.  Reading  in  a  dim 
light  or  the  twilight  is  also  very  bad  for  the  eyes. 

Sewing  and  embroidery  require  the  most  trying  ocular 
labor  and  the  best  conditions  for  illumination.  Working 
on  black  goods  by  artificial  fight  should  be  absolutely 
forbidden. 

Injuries  to  the  Eyes. — The  most  common  injuries  to 
the  eyes  are  the  entrance  of  smaU  particles  of  dust,  cinders, 
steel  fifings,  etc.,  into  the  conjunctival  sac,  or  into  the 
substance  of  the  cornea.  Frequently,  with  the  aid  of  a 
little  winking,  the  tears  wash  away  these  foreign  sub- 
stances, but  if  the  susbtance  lodges  in  the  fining  mem- 
brane of  the  upper  or  lower  fid,  or  is  imbedded  in  the 
cornea,  it  may  be  necessary  to  resort  to  other  means  in 
order  to  remove  them. 

The  fining  membrane  of  the  lower  fid  is  brought  into 
view  by  simple  tension  of  the  lower  fid  downward  by  one 
finger.  If  the  offending  particle  is  not  seen,  the  upper 
fid  should  be  everted.  This  may  be  easily  effected  by  the 
fingers  alone.  The  patient  is  told  to  look  down,  the 
edge  of  the  upper  lid  and  the  lashes  are  seized  by  the 
thumb  and  forefinger  of  the  right  hand,  and  the  fid  is 
drawn  at  first  forward  and  then  downward  away  from  the 
eye,  then  upward  over  the  point  of  the  thumb  or  fore- 
finger of  the  left  hand,  which  is  held  stationary  on  the 
fid  and  acts  as  a  fulcrum.  The  foreign  body  should  be 
removed  with  the  handkerchief,  but,  if  it  is  imbedded,  it 
may  be  necessary  for  a  competent  physician  to  remove  it. 

The  habit  of  opening  the  eyes  when  dipping  the  face 
into  a  basin  of  water,  or  when  diving,  produces  congestion 
and  inflammation  of  the  conjunctiva. 


202  PERSONAL  HYGIENE   FOR  WOMEN 

Symptoms  and  Treatment  of  Conjunctivitis. — The 

eyes  may  be  blood-shot  and  the  hning  membranes  of  the 
lids  intensely  red.  There  is  a  sense  of  irritation  about 
the  eyes  and  an  intolerance  of  light,  with  a  constant  sense 
of  discomfort.  The  sensation  produced  is  that  of  having 
sand  in  the  eyes.  The  eyes  are  heavy,  and  tire  after  using 
them  for  a  short  time. 

The  best  treatment  for  acute  conjunctivitis,  which  is 
so  often  caused  by  the  penetration  of  dust  or  other  foreign 
bodies  into  the  conjunctival  sac,  is  the  application  of 
cold  water.  A  folded  handkerchief  is  wrung  out  of  ice- 
water  and  laid  on  the  closed  Hds.  It  must  be  changed 
every  few  minutes,  so  that  it  shall  not  become  warm; 
two  cloths  are  necessary.  When  the  acute  symptoms 
have  begun  to  abate,  the  patient  will  no  longer  find  these 
applications  grateful,  and  they  must  be  discontinued. 

For  chronic  conjunctivitis  hot  applications  are  the  best. 
For  these,  one  teaspoonful  of  fine  table  salt  may  be  dis- 
solved in  a  pint  of  hot  water,  or  two  teaspoonfuls  of  boric 
acid  may  be  used  instead ;  the  last  named  is  a  mild  anti- 
septic. The  boric  acid  dissolves  very  slowly,  so  that  it  is 
well  to  prepare  enough  in  the  morning  for  the  entire  day. 
One  tablespoonful  of  boric  acid  may  be  put  into  a  quart 
bottle  of  hot  water,  and  be  well  shaken  from  time  to  time, 
until  there  is  a  perfect  solution. 

When  ready  for  use,  half  a  pint  may  be  heated,  poured 
into  a  tumbler,  which  is  then  placed  in  a  basin  of  hot 
water;  this  latter  serves  as  a  water-bath  to  keep  the 
solution  in  the  glass  hot.  The  application  should  be  made 
with  a  rather  thick  wad  of  absorbent  cotton  or  a  piece  of 
fine  cheese-cloth.  The  absorbent  cotton  should  be  picked 
up  with  all  the  water  it  will  hold,  and  be  placed  over  the 
closed  eyes  just  as  hot  as  can  comfortably  be  borne,  and 
held  there  until  it  begins  to  cool,  when  the  procedure 
should  be  repeated.  The  two  eyes  can  be  treated  simul- 
taneously. These  hot  fomentations  should  be  kept  up 
for  ten  minutes,  and  be  repeated  four  times  a  day. 

Trachoma. — This  malady,  of  which  so  much  is  heard 


NERVOUS   SYSTEM   BALANCE   OF  POWER  IN  BODY      203 

now,  is  another  name  for  granular  conjunctivitis  or 
granular  lids.  The  affection  is  very  contagious.  It 
comes  on  slowly,  and  is  frequently  accompanied  by  redness 
and  an  appreciable  degree  of  secretion  in  the  early  stages. 
Presence  of  secretion  or  of  interference  of  the  vision 
should  always  attract  attention. 

Strict  precautions  must  be  taken  that  the  patient's 
handkerchief,  towel,  and  wash-basin  are  not  used  by  other 
members  of  the  family.  Further,  the  other  members  of 
the  family  should  bathe  their  eyes  several  times  a  day  with 
a  solution  of  boric  acid. 

Styes. — Styes  are  a  very  painful  species  of  small  boils 
that  generally  form  on  the  edges  of  the  eyeUds,  They  are 
apt  to  appear  in  succession.  Certain  persons  are  Hable 
to  them  if  the  system  is  run  down  from  general  causes. 
Like  boils  in  other  parts  of  the  body,  they  give  evidence 
of  impaired  nutrition. 

Hot  fomentations  of  boric  acid  solution  will  some- 
times abort  them  if  used  early.  If  pus  has  formed, 
the  stye  must  be  opened  by  an  incision  parallel  to  the  edge 
of  the  hd.  This  should  not  be  attempted  by  any  one 
except  a  physician. 

Color-blindness. — As  a  rule,  about  4  per  cent,  of  males 
and  about  one-half  of  1  per  cent,  of  females  are  color-bhnd. 
The  part  of  the  color  sense  that  is  most  often  deficient 
is  that  for  green  and  red. 

Cataract. — This  is  a  disease  in  which  the  crystalline 
lens  or  its  capsule,  or  both,  lose  their  transparency  and 
become  opaque.  Eventually  total  bhndness  is  the  result. 
Senile  cataracts  appear  after  the  forty-eighth  year.  The 
only  remedy  for  the  disease  is  the  surgeon's  knife. 

Functional  Nervous  Disorders. — Evidences  of  sound 
health  are:  first,  individual  adaptabihty  or  capacity  of 
the  individual  to  easily  adapt  herself  to  extremely  oppo- 
site conditions  of  existence;  second,  endurance,  or  the 
capacity  to  do  a  considerable  amount  of  mental  work  for 
a  short  time  without  suffering  fatigue,  or  to  be  able  to 
quickly  recover  from  the  fatigue;    third,  to  be  able  to 


204        PERSONAL  HYGIENE  FOR  WOMEN 

control  the  emotions;  fourth,  to  be  able  to  resist  morbific 
influence;  that  is,  the  capacity  on  the  part  of  sound 
organs  of  excretion  to  quickly  eHminate  all  poisons  from 
the  system. 

The  signs  of  debihty  are  just  the  reverse:  first,  de- 
formity, obesity,  or  leanness;  second,  personal  inadapta- 
bility, that  is,  when  physical  or  mental  discomfort  is 
caused  by  such  slight  provocations  as  change  of  food, 
clothing,  or  cHmate;  third,  lack  of  endurance,  so  that  a 
long  rest  is  required  to  repair  the  fatigue  incident  to 
slight  exertion;  fourth,  lack  of  control  of  the  emotions; 
fifth,  a  proclivity  to  morbific  influences,  so  that  the 
individual  succumbs  to  every  contagion  or  miasm  that 
she  encounters. 

Nervousness  is  a  disease  of  civilization,  coupled  with 
overwork  and  indoor  life.  The  more  complex  the  environ- 
ment in  which  the  individual  finds  herself,  and  to  which 
she  must  adjust  herself,  the  greater  the  demands  made  on 
the  nervous  system. 

The  extreme  dryness  of  our  climate,  together  with  the 
great  variations  of  temperature  between  winter  and  sum- 
mer and  the  rapid  fluctuations  of  temperature,  predisposes 
to  nervous  disorders. 

Headache. — Headache  is  a  symptom  rather  than  a 
disease,  but  there  is  no  symptom  which  requires  more 
careful  investigation  of  its  cause  than  that  of  headache. 
It  occurs  at  all  ages,  but  is  most  common  from  ten  to 
twenty-five  years  and  from  thirty-five  to  forty-five  years. 
Women  suffer  from  headache  more  than  men,  in  the 
proportion  of  about  three  to  one.  Headaches  are  most 
common  in  the  spring  and  fall  of  the  year  and  in  the 
temperate  cHmates. 

Causes  of  Headache. — These  may  be  classified  into  those 
in  w^hich  the  blood  is  at  fault;  reflex  causes;  various 
nervous  disorders;   and  organic  diseases. 

The  blood  may  be  impoverished,  as  in  the  case  of  anemia, 
where  there  is  a  deficiency  in  hemoglobin;  but  by  far  the 
most  frequent  cause  of  headache  is  where  the  blood  is 


NERVOUS   SYSTEM  BALANCE  OF   POWER  IN  BODY      205 

disordered,  as  in  gout,  rheuraatism,  kidney  diseases, 
diabetes,  and  the  infectious  fevers  and  malaria. 

Among  the  more  common  reflex  causes  are  eye-strain, 
especially  errors  of  refraction;  disorders  of  digestion, 
particularly  constipation;  and  pelvic  disorders,  as  in 
inflammation  of  the  pelvic  viscera. 

Functional  diseases  of  the  nervous  system  causing  head- 
ache are  overwork,  neurasthenia,  hysteria,  epilepsy,  and 
neuritis. 

Among  the  most  common  of  the  organic  diseases  is 
arteriosclerosis;  other  diseases  are  meningitis  and  brain 
tumors. 

Symptoms. — The  pain  is  often  dull  in  character  and 
rendered  worse  by  stooping;  the  location  of  the  pain 
depends  on  the  cause  of  the  headache.  The  most  common 
variety  is  over  the  forehead  or  eyes.  In  eye-strain  the 
pain  may  either  be  in  the  front  or  back  of  the  head. 
In  indigestion,  the  pain  is  most  frequently  over  the  eyes, 
but  it  may  also  be  on  the  top  of  the  head.  In  anemia 
the  pain  may  be  either  frontal  or  diffuse.  In  pelvic  dis- 
orders the  pain  is  generally  at  the  base  of  the  brain, 
though  it  is  sometimes  in  the  top  of  the  head. 

Neuralgic  headaches  are  generally  characterized  by 
sharp  paroxysmal  attacks,  located  in  the  temporal  regions, 
and  associated  with  pain  in  other  parts  of  the  body.  It 
is  perhaps  most  frequently  caused  by  anemia. 

In  hysteria  the  headaches  are  characterized  by  a 
circumscribed  pain — it  has  been  likened  to  the  driving 
of  a  nail  into  the  head. 

In  migraine  the  pain  is  paroxysmal  and  intensely 
severe;  it  is  frequently  caused  by  some  poison  in  the 
blood,  as  in  autointoxication,  due  to  failure  of  proper 
regulation  of  the  bowels,  also  by  pelvic  disorders. 

Treatment. — The  treatment  is  constitutional,  and  ia 
based  on  the  removal  of  the  cause.  First,  there  should 
be  a  regulation  of  the  diet,  a  free  evacuation  of  the  bowels, 
and  their  proper  regulation.  In  every  case  of  headache 
there  should  be  an  examination  of  the  urine.     Often  there 


206  PERSONAL  HYGIENE  FOR  WOMEN 

is  some  congestion  of  the  kidneys  where  it  is  least  sus- 
pected. If  the  headache  is  persistently  made  worse  by 
reading  or  sewing,  the  patient  should  be  referred  to  a 
competent  oculist.  An  inquiry  should  always  be  made 
into  the  condition  of  the  menstrual  function,  backache, 
and  leukorrhea.  Any  marked  disorders  here  will  neces- 
sitate a  gynecologic  examination. 

For  the  immediate  relief  of  migraine,  the  patient  should 
go  at  once  to  bed  and  drink  a  glass  of  hot  water;  some- 
times a  cup  of  hot  tea  gives  great  relief.  No  food  should 
be  taken  for  from  six  to  twelve  hours,  according  to  the 
severity  of  the  case.  The  room  must  be  kept  dark  and 
quiet  and  the  head  high. 

A  strip  of  prepared  mustard  leaf,  5  inches  wide  by  8 
inches  long,  should  be  cut,  and  a  piece  of  cheese-cloth,  6 
or  8  layers  thick,  should  be  folded  the  same  size.  The 
cheese-cloth  is  then  wrung  out  of  hot  water,  and  the 
mustard  leaf  is  quickly  dipped  into  the  same.  The  cheese- 
cloth is  placed  on  the  back  of  the  neck,  between  it  and 
the  mustard  leaf.  The  clothes  should  be  kept  dry  by 
a  folded  napkin.  In  this  way  the  mustard  may  be  kept 
on  from  six  to  eight  minutes,  until  it  begins  to  burn 
and  the  skin  get  red.  If  left  on  too  long,  the  mustard 
may  produce  the  most  painful  kind  of  a  blister.  When 
taken  off  the  neck,  the  mustard  may  be  put  on  over  the 
stomach. 

The  medicinal  treatment  must  be  directed  by  the  physi- 
cian, but  a  perfectly  safe  prescription,  and  one  which  may 
be  kept  on  hand,  is  the  following:  Take  of  sodium  bromid, 
15  grains;  of  essence  of  peppermint,  10  drops;  and  of 
water  a  suflScient  quantity  to  make  1  dram.  Mix  well. 
The  dose  may  be  repeated  in  three  hours  if  necessary. 
This  prescription  should  be  put  up  by  a  good  druggist,  in 
a  three-ounce  quantity.  Sometimes  relief  is  afforded  by 
1  teaspoonful  of  the  aromatic  spirits  of  ammonia,  taken 
in  four  tablespoonfuls  of  water,  and  this  is  about  the  right 
quantity  of  water  to  take  any  liquid  medicine  in.  At 
night  2  grains  of  calomel  should  be  taken,  so  that  the 


NERVOUS  SYSTEM  BALANCE   OF   POWER   IN  BODY      207 

patient  shall  not  be  disturbed  through  the  night,  and  it  is 
not  so  apt  to  cause  nausea  as  when  taken  through  the 
day. 

Neurasthenia  or  Nervous  Prostration. — This  disease 
first  saw  hght  in  the  United  States,  and  was  christened  by 
Beard  as  an  American  disease  that  was  absent  from  no 
household  in  which  the  inhabitants  used  their  brains. 
It  is  certainly  much  more  prevalent  in  this  than  in  any 
other  coimtry.  Americans  scarcely  treat  their  bodies 
with  more  consideration  than  their  automobiles;  they  put 
on  high  pressure  and  speed  them  to  the  utmost.  Add  to 
the  high  pressure  under  which  we  live  that  other  fact  of 
heredity,  that  many  persons  are  born  with  unstable  nerve- 
cells,  and  may  be  nervously  bankrupt,  and  it  is  not  difficult 
to  understand  that  50  per  cent,  of  Americans  are  suffering 
in  some  degree  from  lowered  nerve  tone. 

Causes  of  Neurasthenia. — All  classes  of  men  and  women 
who  use  their  brains  severely,  and  who  have  seasons  of 
excessive  anxiety  and  responsibility,  are  subject  to 
neurasthenia.  We  have  seen  that  fatigue  was  caused 
by  the  accumulations  of  toxins  in  the  body,  due  to  muscular 
activity,  but  these  toxins  miay  also  be  caused  by  intel- 
lectual overwork  or  anxiety  over  domestic  or  business 
affairs. 

Other  causes  are  the  intemperate  amount  of  intellectual 
work  which  is  forced  on  the  brain,  and  the  excessive 
indulgence  of  the  emotions  and  the  passions.  Combined 
with  the  strenuousness  of  life  is  the  large  element  of 
uncertainty,  the  intense  anxiety,  and  the  restless  en- 
ergy which  is  the  price  of  success.  Added  to  these  may 
bo  lack  of  suitable  and  sufficient  recreation  and  short 
hours  of  restless  sleep;  the  restrictions  of  a  narrow  lot, 
lonehness,  and  isolation,  the  frequent  repetitions  of  un- 
interesting tasks,  added  to  the  burdens  of  maternity, 
domestic  cares,  and  worries. 

In  cities  the  ear-strain  caused  by  the  incessant  noises 
of  the  street,  the  amount  of  work  done  by  insufficient 
and  improper  lighting,  the  unsanitary  mode  of  life,  the 


208  PERSONAL  HYGIENE   FOR  WOMEN 

improper  diet,  the  monotonous  and  infertile  work,  the 
unhappiness  and  discontent  bred  of  a  life  of  idleness,  or 
one  given  to  society  and  gambling,  whether  bridge  whist 
or  poker,  the  senseless  bolstering  of  shattered  nerves  with 
alcoholic  stimulants  and  beverages,  patent  medicines,  and 
hypnotics,  all  add  their  quota  to  the  breaking  down  of  the 
nervous  system. 

A  man  can  do  a  prodigious  amount  of  work  if  he  only 
varies  it  with  play  which  really  amuses  him,  or  if  he  sub- 
stitutes for  mental  occupation  those  which  involve 
bodily  exercises. 

In  so-called  latent  gout  insomnia  is  a  frequent  symp- 
tom, or  insomnia  may  develop  as  the  result  of  bad  nervous 
habits,  Insortmia  from  whatever  cause  is  followed  by 
the  impairment  of  nerve  substance  and  an  overloading 
of  the  body  with  toxins.  This  continued  nerve  exhaus- 
tion leads  to  oxaluria,  uric  acid,  gout,  anemia,  gastric 
and  intestinal  dyspepsia,  muscular  insufficiency,  and 
precordial  distress. 

Whatever  enfeebles  the  body  by  overtaxing  the  nervous 
system  the  waste  is  in  excess  of  the  repair,  in  all  over- 
work the  destructive  metamorphosis  is  greater  than  the 
reparative  processes,  and  so  there  is  an  accumulation  of 
toxic  products  and  a  more  or  less  severe  and  permanent 
injury  is  done  the  nervous  system. 

Other  causes  of  neurasthenia,  not  so  generally  recog- 
nized as  overwork,  are  to  be  found  in  the  pathologic  con- 
ditions of  the  intestinal  canal,  which  becomes  a  veritable 
culture  tube,  and  absorption  from  this  into  the  blood  con- 
stantly takes  place.  And  this  condition  of  putrefaction 
has  to  be  overcome  before  relief  can  be  afforded,  and  in 
many  cases  this  condition  is  associated  with  an  insuffi- 
ciency of  the  elimination  of  urine. 

The  large  intestine  is  the  seat  of  an  enormous  bacterio- 
logic  flora ;  they  are  not  there  by  millions,  but  by  billions. 
Some  of  them  are  harmless,  but  not  all  of  them,  and  if 
these  pathogenic  bacteria  are  present  in  sufficient  quan- 
tity, they,  too,  may  produce  symptoms  of  mild  poisoning. 


NERVOUS  SYSTEM  BALANCE   OF  POWER   IN  BODY      209 

So,  too,  may  mere  indigestion,  or  the  malfunction  of  any 
other  organ,  torpidity  of  the  liver,  a  deficiency  of  the  ex- 
cretion of  bile,  which  is  generally  accompanied  by  con- 
stipation. 

The  Symptoms  of  Neurasthenia. — ^The  symptoms  are 
essentially  those  of  chronic  fatigue,  which  has  become  ex- 
aggerated and  pathologic.  They  may  be  classified  as 
sensory,  motor,  psychic,  and  somatic.  The  sensory 
symptoms  first  noticed  are  those  of  generaHzed  fatigue, 
with  such  localized  sensations  as  headache,  backache, 
and  Umbache.  The  motor  symptoms  are  muscular  fa- 
tigue, muscular  weakness,  and  muscular  exhaustion  on 
slight  exertion.  The  psychic  symptoms  are  manifested 
by  a  diminution  in  the  capacity  for  sustained  mental 
effort  and  the  spontaneity  of  thought  and  exhaustion  after 
slight  mental  effort.  The  somatic  symptoms  show  them- 
selves in  atony  of  the  digestive  tract  and  the  circulatory 
apparatus,  with  disturbances  of  the  secretions. 

Headache  is  one  of  the  most  common  symptoms  of 
locahzed  fatigue,  and,  associated  with  this,  may  be  a 
sense  of  constriction  about  the  head,  and  there  may  be 
either  a  sense  of  lightness  or  fulness  of  the  head. 

A  woman  who  is  chronically  tired  loses  all  her  personal 
vigor,  force,  aggressiveness,  and,  above  all,  will  power. 
Associated  with  this  lack  of  will  power  are  hesitation,  in- 
decision, a  marked  irritability,  and  timidity.  Neuras- 
thenic patients  are  subject  to  spontaneous  attacks  of 
fear,  causeless  In  origin,  and  generaHzed  in  character. 
These  attacks  may  be  accompanied  by  paUor  of  the  face 
and  palpitation  of  the  heart,  just  as  in  normal  fear.  The 
tired  woman  is  a  cross  woman.  The  irritability  shows 
marked  impairment  of  the  power  of  inhibition. 

The  Rational  Treatment  of  Neurasthenia. — First  of  all, 
there  must  be  a  removal  of  the  cause  which  has  produced 
it.  There  are  two  distinct  classes  of  cases — the  over- 
worked and  the  idle.  The  first  class,  and  the  most  im- 
portant to  the  world,  are  the  overworked.  We  may  have 
to  deal  with  the  intellectually  overworked,  in  which  the 
14 


210  PERSONAL  HYGIENE   FOR  WOMEN 

mental  overwork  was  combined  with  financial  anxieties, 
domestic  difi5culties,  or  lack  of  success  in  their  work,  or 
the  cause  may  have  been  the  tremendous  responsibilities 
of  their  positions,  which  involved  the  Hves  or  fortunes  of 
many  people.  Added  to  this  great  strain  and  overwork, 
has  been  a  lack  of  proper  intervals  for  rest,  recreation, 
and  sleep,  and  the  body  has  become  a  storehouse  for  vari- 
ous toxins,  and  so  is  suffering  from  both  acute  and  chronic 
poisoning. 

This  class  of  patients  must  have  the  most  rigid  rest 
treatment,  such  as  was  prescribed  by  Weir  Mitchell  years 
ago.  It  is  most  important  that  the  patient  should  be 
removed  from  her  old  surroundings;  if  this  is  not  possible, 
she  should  be  isolated  on  the  top  floor  of  the  house  with  a 
good  nurse.  The  room  selected  must  be  bright  and  cheer- 
ful, with  plenty  of  sunshine  and  fresh  air;  a  window  should 
be  open  practically  all  the  time,  for  oxygen  and  sunshine 
are  two  of  the  best  restoratives.  The  diet  must  be  easily 
digested  and  very  nutritious.  The  patient  should  be 
urged  not  to  use  her  mind  at  all.  Carefully  selected  short 
stories  may  be  read  aloud  by  the  nurse;  the  reading  should 
not  be  continued  for  more  than  haK  an  hour  at  a  time. 

A  great  deal  may  be  done  to  ehminate  these  toxins  from 
the  system  by  the  proper  use  of  electric-Hght  baths,  fol- 
lowed by  the  shampoo  and  the  percussion  douche;  mass- 
age with  salt  water,  salt  rubs,  and  electricity. 

In  most  cases  a  month  of  this  absolute  rest  is  as  long  as 
is  beneficial  to  the  patient.  And  for  most  of  them  the 
seashore  is  the  best.  There  should  be  enough  going  on  to 
be  diverting  without  being  overtaxing,  and  a  climate 
should  be  selected  which  is  warm  enough  for  the  patient 
to  live  out-of-doors.  There  should  be  short  walks,  drives, 
sails,  etc.,  and  this  outdoor  Hfe,  with  a  contemplation  of 
nature,  is  the  most  powerful  restorative.  The  grandeur 
of  nature,  whether  it  is  the  mighty  forests,  with  their  re- 
freshing shade  and  quiet,  or  even  stretched  in  a  hammock 
watching  the  sky  and  trees,  or  the  constant  surging  of  the 
vast  sea,  bringing  rest  in  its  unceasing  restlessness,  with 


NERVOUS   SYSTEM   BALANCE   OF   POWER   IN   BODY      211 

the  ships  sailing  lazily  along,  until  the  whole  fades  away 
in  the  distant  horizon.  In  the  vastness  of  the  universe,  the 
ego  becomes  contemptibly  unimportant  and  insignificant. 

After  several  months  spent  in  this  way  the  body  has 
gotten  rid  of  its  toxins,  nerves  and  muscles  are  rested,  and 
through  the  soothing  influence  of  nature  the  neurasthenic 
is  gradually  trained  back  to  a  healthier  habit  of  thought 
and  a  more  rational  frame  of  mind.  There  is  substituted 
for  the  morbid  emotional  complex  a  feeling  of  pleasure 
and  energy.  Reason  and  judgment  reassert  their  sway; 
outdoor  life  quickens  the  perceptions,  and  forms  tranquil- 
izing  memory  pictures  on  the  brain  that  return  later  to 
solace  and  refresh  the  individual. 

There  is  another,  and  a  very  large  class,  of  cases  among 
women  of  leisure  who  have  suffered  all  their  lives  from 
a  lack  of  a  vocation ;  they  have  nothing  to  think  of  except 
themselves.  They  do  not  know  what  it  is  to  be  quite  well; 
they  travel  from  one  part  of  the  country  to  another,  and 
from  one  country  to  another,  but  they  never  rise  above  a 
certain  level  of  invahdism.  They  are  self  centered,  and 
what  they  need  is  the  work  cure.  In  the  majority  of 
cases,  before  these  patients  can  be  restored  to  health, 
powerful  habits  must  be  eradicated,  new  interests  in 
others  must  be  supplied  to  supplant  the  most  intense  egot- 
ism, new  paths  must  be  hewn  out  in  the  brain,  the  will 
must  be  recreated,  and  character  can  only  be  imparted  by 
those  who  possess  it. 


CHAPTER  VI 

THE  HYGIENE  OF  THE  MIND  AND  ITS  RELATION 
TO  THE  PHYSICAL  HEALTH 

Heredity;  Temperament;  Social  Instincts;  Fear. 

Mental  Development;  Self-control,  the  Moral  Sense,  the  Religious 
Instincts;  the  Advantages  of  College  Life;  Balance  of  the  Mental 
Faculties;  the  Effects  of  the  Higher  Education  of  Women. 

The  Environment;  the  Choice  of  Friends;  Literature. 

The  Power  of  the  Will  or  Inhibition;  the  Effect  of  the  Mental 
Attitude  on  the  Physical  Health;  A  Definite  Occupation  a  Physical 
Necessity;  the  Psychology  of  Success. 

The  solidarity  of  brain  and  mind  is  an  axiom  of  modem 
medicine,  and  it  is  a  fundamental  principle  that  must  be 
kept  constantly  in  view  in  all  physical  and  mental  training. 
Hitherto  unsoundness,  inefficiency,  and  weakness  of  mind 
have  only  been  lightly  touched  upon  in  preventive  medi- 
cine, but  the  importance  of  the  mind  as  the  chief  factor  in 
health  and  disease  is  so  paramount  that  it  can  no  longer  be 
ignored. 

The  problems  that  present  themselves  to  the  mother  and 
the  educator  to-day  are  practically  the  same,  and  the 
mother  is  one  of  the  most  potent  educators  that  we  have — 
how  the  mind  can  best  be  strengthened,  broadened,  and 
be  made  the  most  efficient  working  instrument  possible 
through  the  application  of  modem  scientific  and  physio- 
logic knowledge.  These  are  questions  of  vital  importance 
to  the  human  race. 

Heredity. — Holmes  says:  "Each  one  of  us  is  only  the 
footing  up  of  a  double  column  of  figures  that  goes  back  to 
the  first  pair.  Every  unit  tells,  and  some  of  them  are 
plus  and  some  of  them  are  minus.  We  are  mainly  nothing 
but  the  answer  to  a  long  sum  in  addition  and  subtraction. 

212 


HYGIENE  OF  MIND  AND   ITS  RELATION  TO  HEALTH     213 

Slight  obliquities  are  what  we  most  have  to  do  with  in 
education." 

There  are  certain  hereditary  predispositions  that  will 
develop  under  certain  conditions;  some  of  them  are  good, 
some  are  evil;  that  is,  with  the  natural  development  of  the 
mind,  certain  pecuHarities  of  the  ancestors  wih  be  repro- 
duced. The  problems  suggested  are  how  the  mind  can 
best  be  developed,  educated,  and  trained,  so  that  heredi- 
tary weaknesses  may  be  counteracted  or  held  in  abeyance, 
and  that  latent  hereditary  talents  may  be  discovered  and 
developed. 

The  first  proposition  that  we  have  to  face  is  that  Hke 
produces  like.  There  are  modes  of  education,  of  conduct 
in  hfe,  and  of  occupation  that  should  be  avoided  where  a 
boy  or  girl  is  handicapped  by  a  bad  heredity.  There 
are  special  precautions  and  attention  to  physiologic  laws 
which  would  save  the  minds  of  many  young  men  and 
women  with  a  bad  heredity  from  passing  into  a  state  of 
inefiiciency  and  actual  disease.  Heredity  implies  only 
potentiahty  toward  good  or  evil,  and  the  latter  may  be 
averted  by  knowledge  and  the  proper  practice. 

Temperament. — This  comprises  the  general  make  up 
of  the  individual,  the  shape  of  the  head,  the  appearance 
of  the  eyes,  the  mobility  of  the  features,  the  texture  of  the 
hair  and  skin,  and  the  kind  of  movement.  The  recog- 
nition of  the  kind  of  temperament,  and  a  suitable  training 
for  its  best  development,  is  of  the  greatest  importance  in 
attaining  good  health  and  success  in  life. 

There  are  four  general  typeQ  of  temperaments — the 
nervous,  the  phlegmatic,  the  arthritic,  and  the  scrofulous 
or  lymphatic. 

The  nervous  temperament  has  certain  marked  char- 
acteristics, as  the  small,  wiry  figure,  the  well-shaped  head, 
the  bright,  restless  eye,  nervous  bearing,  highly  strung 
and  sensitive  nerves,  feehng  pain  keenly  and  bearing  it 
badly.  This  woman  is  imaginative,  sensitive,  fond  of 
intellectual  work,  often  artistic  and  ambitious.  In  her 
the  brain  and  mind  are  dominant  above  aU  else.     When 


214  PERSONAL  HYGIENE  FOR  WOMEN 

run  down,  this  woman  will  be  difficult  to  bring  up  again  to 
the  normal  level.  She  will  grow  thin,  dyspeptic,  irritable, 
and  often  neuralgic.  She  will  be  peculiarly  liable  to  ner- 
vous disorders. 

This  temperament  has  its  special  temptations — alcohol 
and  sedative  drugs  are  two  of  them.  Alcohol  is  not  taken 
steadily  or  for  social  reasons,  but  for  the  effect  of  alcohol 
on  the  brain,  and  there  is  the  greatest  danger  of  becoming 
addicted  to  alcoholic  habits,  and  finally  of  becoming  an 
uncontrollable  dipsomaniac. 

The  phlegmatic  or  bilious  temperament  relates  more  to 
the  training  of  the  body,  since  in  this  class  of  cases  the  mind 
is  not  exposed  to  the  same  dangers,  but  the  oversanguine 
temperament  has  its  own  dangers,  which  may  lead  to  lack 
of  effort,  speculation,  and  financial  ruin. 

The  arthritic  have  a  predisposition  to  both  rheumatism 
and  gouty  disorders,  to  which  they  are  distinctly  more 
liable  than  others,  and  the  fact  that  there  is  this  latent 
tendency  should  be  taken  into  consideration  during  child- 
hood and  youth. 

Social  Instincts. — Social  instincts  lie  at  the  foundation 
on  which  the  family  and  community  is  based.  It  may 
be  said  that  any  individual  who  is  destitute  of  them  is  in 
an  abnormal  condition,  hence  a  right  training  of  the  social 
instincts  is,  beyond  doubt,  one  of  the  most  important  means 
of  securing  happiness  to  the  individual  and  order  to  society. 
The  child's  or  youth's  relation  to  others,  her  affection  for 
others,  and  her  altruistic  practices,  all  go  for  the  making 
of  society,  good  citizenship,  and  patriotism  in  the  race. 

At  the  school  age  the  social  instincts  are  one  of  the 
strongest  elements  in  life,  and  one  of  the  most  powerful 
adjuncts  in  developing  mind  and  body.  The  cravings  of 
young  women  for  social  amenities  are  stronger,  and  her 
deprivation  of  them  more  hurtful,  than  in  the  case  of 
young  men.  There  are  few  girls  in  whom  it  does  not  re- 
quire some  regulation.  The  strain  of  too  much  social 
life  is  injurious;  social  dissipation  cannot  be  combined 
with  school  life  without  wrecking  the  health  of  the  young 


HYGIENE   OF  MIND   AND   ITS  RELATION  TO  HEALTH     215 

woman;  nervousness,  anemia,  and  mental  depression 
follow. 

That  individual  cannot  be  said  to  be  healthy  mentally 
whose  social  instincts  are  poor  and  perverted.  Commonly 
one  of  the  first  symptoms  of  a  disordered  mind  is  the  dimi- 
nution of  the  social  instinct.  The  insane  are  notoriously 
asocial. 

Fear. — This  is  one  of  the  most  elemental  and  primitive 
of  the  emotions.  Biologists  assure  us  that  fear  and  sur- 
prise were  the  first  of  the  emotions  to  be  developed,  and 
that  the  feeling  of  the  ludicrous  was  the  last.  Darwin 
says  that  the  earthworm  knows  fear,  and  darts  into  its 
burrow  Hke  a  rabbit  when  alarmed.  So  we  see  that  fear 
is  common  to  all  forms  of  animal  existence,  even  to  the 
lowest.  This  universality  of  fear  has  come  about  through 
the  working  of  the  laws  of  natural  selection,  which  pre- 
scribe that  only  those  creatures  shall  survive  that  can 
best  adjust  themselves  to  their  environment.  Within 
limits,  fear  as  a  primary  instinct  has  been  and  is  eminently 
useful.  It  is  the  cry  of  alarm  raised  by  the  senses  which 
act  as  guardians  of  the  body,  and,  at  a  signal,  in  virtue  of 
the  nervous  automatism,  the  organism  is  put  in  a  position 
of  defense.  On  the  other  hand,  fear  may  serve  to  paralyze, 
as  has  been  observed  in  the  case  of  birds,  many  of  which, 
though  scarcely  wounded  by  the  small  shot,  fall  to  the 
ground  as  if  struck  by  Hghtning,  panting  with  wide-open 
eyes.  In  human  life,  while  fear  incites  to  activity,  it  may 
also  paralyze  that  activity. 

Mosso  says  that  the  fear  that  young  children  have  of 
cats  and  dogs,  before  they  have  learned  why  they  are  to 
be  feared,  is  a  consequence  of  heredity.  We  are  born  to  a 
heritage  of  fear.  If  we  fear  ghosts  and  demons  less,  we 
fear  microbes  and  bacteria  more.  The  professional  or 
business  man  fears  failure,  but  fear  should  be  a  guardian, 
not  a  jailer.  A  healthy  fear  of  indigence  will  lead  to  thrift, 
industry,  and  such  measures  as  will  secure  one's  personal 
independence.  Up  to  a  certain  point,  fear  is  a  protection, 
but  beyond  that  it  paralyzes. 


216  PERSONAL  HYGIENE  FOR  WOMEN 

Mental  Development. — We  note  that  at  birth  the 
brain  is  mindless,  and  that  the  brain-cells,  which  are  the 
vehicle  of  the  mind,  undergo  their  greatest  development 
during  childhood  from  stimuli  coming  from  without  the 
body.  The  brain-cells  possess  infinite  possibilities  and 
potentialities.  They  are  developed  from  the  stimuH  from 
without  through  the  eyes,  ears,  touch,  taste,  and  smell. 
There  is  another  series  of  constant  impressions  which  are 
received  from  within  the  body,  and  these  come  from  the 
muscles. 

These  impressions,  conveyed  to  the  brain-cells  from  the 
body,  and  from  the  outer  world  beyond  the  body,  leave 
a  fixed  registration,  the  writing  on  the  brain-cells  has 
begun,  and  this  constitutes  memory;  and  the  imprint  on 
these  cells  is  similar  to  that  which  type  leaves  of  letters 
and  words  on  the  page  of  the  printed  book.  These  printed 
impressions  on  the  cells  can  be  revived  and  seen  and  heard 
by  the  mental  consciousness,  just  as  a  printed  book  can  be 
opened  and  seen  and  read  by  its  owner. 

The  natural  quahties  of  the  mind  are  imitation,  acquisit- 
iveness, emotionalism,  and  imagination. 

The  force  of  example  in  the  home,  at  school,  and  in  the 
book  world  is  among  the  most  potent  influences  in 
molding  character.  The  young  girl  instinctively  imi- 
tates her  mother,  her  friends  in  real  life,  and  in  her  book 
world,  and  the  woman  will  be  the  composite  production, 
combining  traits  of  all  of  these,  which  will  be  ingrafted  on 
the  ancestral  traits  which  have  been  inherited. 

In  young  children  it  is  difficult  to  decide  where  the 
imagination  leaves  off  and  the  spirit  of  tmtruthfulness 
begins.  In  any  case,  the  tendency  to  exaggeration  and 
untruthfulness  are  so  prevalent  in  childhood  that  it  must 
be  checked  at  the  earfiest  signs  of  its  appearance.  The 
vice  becomes  so  deep  rooted  that  it  affects  the  mind  in  aU 
its  workings  and  the  entire  fife  as  well.  It  follows  men  and 
women  into  their  business  careers,  their  scientific  life,  and 
their  professions. 

Professor  Swift,  in  a  very  interesting  study  of  the  devel- 


HYGIENE   OF  MIND  AND   ITS  RELATION  TO   HEALTH     217 

opment  of  the  mind,  invokes  the  aid  of  biology  to  show  that 
all  children  are  but  little  animals,  having  no  inborn  notions 
of  right  and  wrong,  inheriting  no  sense  of  justice;  savage, 
by  nature,  and  predatory  by  instinct. 

He  finds  a  psychic  justification  for  fighting  among 
boys.  "Fighting  in  some  form,"  he  says,  "is  one  of  the 
first  means  by  which  the  mind  becomes  accustomed  to 
intense  action.  To  fight  well,  a  boy  must  be  capable  of 
severe  concentration   of  attention." 

And  he  has  found  the  age  at  which  boys  come  to  think 
that  laws  and  the  recognized  rules  of  right  conduct  should 
be  voluntarily  respected  varies  from  fifteen  to  seventeen 
years  and  older.  These  figures  are  approximately  correct 
for  girls. 

Absolute  truthfulness,  square  dealing,  honesty,  honor, 
and  an  es'prit  de  corps  should  be  demanded.  Hitherto 
these  principles  have  not  been  sufiiciently  inculcated  in 
girls  as  the  fundamental  principles  on  which  life  must  be 
met.  The  discipline  has  been  too  lax  in  the  home  and  in 
the  school ;  it  is  that  of  implicit  and  prompt  obedience  on 
the  word  of  command;  the  proper  subjection  to  and  res- 
pect for  those  placed  in  authority;  the  kind  of  discipline 
given  in  business  life,  the  hospital,  and  the  army,  and  the 
lack  of  which  has  cost  so  much  happiness  and  so  many 
thousands  of  lives. 

Self-control. — The  perfect  capacity  for  self-control  in 
all  directions  and  at  aU  times  is  the  ideal  state  at  which  we 
aim.  It  is  the  standard  aimed  at  by  developing  the  power 
of  the  will  and  the  strength  of  inhibition.  The  great  difii- 
culties,  the  magnitude  of  the  task,  may  be  conceived  of 
from  the  saying  of  the  wisest  of  aU  men : "  He  who  conquers 
his  own  spirit  is  greater  than  he  who  taketh  a  city."  The 
reason  is  plainly  evident — aU  the  hardest  battles  of  fife 
must  be  fought  out  alone,  there  is  a  feeling  of  isolation,  as 
if  one  were  struggling  alone  against  the  combined  forces 
of  the  imiverse,  and,  at  the  same  time,  there  is  going  on 
the  struggle  for  the  mastery  between  the  two  conflicting 
natures;  "  When  I  would  do  good,  evil  is  present  with  me." 


218  PERSONAL  HYGIENE   FOR  WOMEN 

^Vllel■eas,  in  concerted  action  there  is  a  feeling  of  sympathy, 
of  reinforcement  from  outside  help,  and  the  pleasant  stim- 
ulation of  competition. 

If  youth  were  taught  that  certain  enemies  were  going 
to  present  themselves  on  the  field,  that  they  come  for  the 
most  part  in  the  first  instance  single  handed,  and  if  grappled 
with  one  at  a  time,  and  the  contest  between  right,  and 
perhaps  inclination,  be  then  and  there  fought  to  a  finish, 
each  successive  time  the  conflict  would  be  easier  and  the 
victory  more  certain ;  that  in  losing  such  a  battle  there 
must  always  be  a  certain  loss  of  self-respect,  a  feeling  of 
moral  weakness,  it  may  be  even  so  slight  a  fault  as  the 
exaggeration  of  facts;  while,  on  the  other  hand,  a  victory 
always  gives  something  of  the  same  feehng  of  exultation 
that  one  has  in  any  fairly  won  contest  or  game.  A  feeling 
of  pleasurable  superiority,  of  having  one's  self  well  in  hand. 
In  the  moral  habits  every  gain  on  the  wrong  side  undoes 
the  effects  of  many  conquests  on  the  right.  The  training 
of  the  wiU  becomes  the  most  vital  of  all  problems.  Noth- 
ing that  is  learned  in  youth  is  really  so  valuable  as  the 
power  and  habit  of  self-restraint,  of  self-sacrifice,  of  ener- 
getic, continuous,  and  concentrated  effort. 

The  Moral  Sense. — From  fifteen  to  twenty-five  years  of 
age  is  the  most  crucial  period  of  life  in  regard  to  the  hygiene 
of  the  mind.  It  is  during  this  period  that  the  brain 
first  exhibits  some  of  its  strongest  hereditary  tendencies. 
While  such  mental  factors  in  human  life  as  conduct  and 
character  are  being  consolidated,  as  they  now  are,  heredi- 
tary predispositions  manifest  themselves,  teUing  for  good 
or  evil,  for  success  or  failure. 

The  acquisitions  then  made  are  critical  in  the  extreme 
and  often  final.  The  real  love  of  right,  hatred  of  wrong, 
duty,  conscience,  religion,  become  soHd  and  effective  in 
forming  character. 

The  emotional  nature  instinctively  shows  a  leaning 
toward  the  opposite  sex ;  love  between  the  sexes  toward  the 
close  of  adolescence  is  the  most  intense  and  most  unreason- 
ing of  human  passions.     The  sense  of  right,  wrong,  and 


HYGIENE   OF  MIND   AND   ITS  RELATION  TO   HEALTH     219 

duty  become  active  principles,  dominating  the  character, 
There  are  yearnings  after  the  ideal,  an  intense  scorn  of  and 
hatred  of  evil.  The  purposes  in  life  are  then  shaped. 
The  impressions  and  resolutions  then  formed  affect  the 
whole  tenor  of  the  woman's  life,  as  a  rule,  more  than  at 
any  other  time. 

The  capacity  to  feel  pleasure  reaches  its  greatest  inten- 
sity. The  sex  relations  are  built  up  on  safe  and  natural 
lines,  regulated  by  family  Hfe,  social  feelings,  and  the  carry- 
ing of  the  thoughts  and  the  emotions  into  other  channels, 
controlled  by  certain  instinctive  natural  tendencies,  by 
morality  and  rehgion.  To  think  and  feel  properly  should 
mean  to  act  rightly  as  a  physiologic  corollary. 

Music,  hterature,  and  art,  imaginative  works  of  aU 
sorts,  mix  themselves  up  with  the  sex  feeling,  so  that  the 
two  help  to  form  the  emotional  nature.  Far-away  glimpses 
of  poetic  feeling,  pleasurable  altruism,  citizenship,  and 
patriotism  show  themselves  in  the  earlier  stages  and  give 
direction  to  hfe  in  the  later.  The  whole  period  is  one  of 
immense  importance  for  the  health  and  happiness  of  the 
remainder  of  hfe,  and  the  risks  to  the  body  and  mind  are 
then  very  great.  A  fact  which  is  of  great  importance,  and 
which  is  especially  true  of  adolescence,  is  that  it  is  possible 
by  undue  pressure  to  use  up  stores  of  energy  that  should 
have  been  spread  out  over  very  long  periods.  Through 
such  overexertion  in  study  or  in  games  too  heavy  a  drain 
is  made  on  futurity,  and  mental  disorders  at  this  time  are 
by  no  means  infrequent,  mental  depression  being  generally 
the  first  to  appear.  This  is  more  especially  true  in  the 
descendants  of  neurotic  famihes.  The  subjects  are  troubled 
with  neuralgias,  insomnias,  and  there  is  a  pessimistic  view 
taken  of  Hfe. 

The  Religious  Instincts. — Mobius  says,  "  We  reckon  the 
downfall  of  reHgion  as  one  of  the  causes  of  mental  and 
nervous  diseases.  Rehgion  is  essentially  a  comforter. 
It  builds  for  the  man,  who  stands  amid  the  evil  and  misery 
of  the  world,  another  and  fairer  world.  Besides  his  daily 
careful  hfe,  it  lets  him  lead  a  second  and  purer  hfe.     The 


220  PERSONAL  HYGIENE   FOR  WOMEN 

consciousness  of  being  within  the  hand  of  Providence,  and 
the  confident  hope  of  a  future  redemption,  is  a  support  to 
the  believer  in  his  work  and  care,  for  which  unbeHef  has 
no  compensation.  Meditation  calms  and  refreshes  him 
like  a  heaHng  bath.  Worship  breaks  in  upon  the  daily- 
drudgery  of  his  days  with  rest  and  meeting."  The  moral- 
ity of  a  nation  suffers  most  severely  through  the  downfall 
of  its  rehgion,  as  experience  has  always  and  everywhere 
proved. 

The  rehgious  instinct  has  a  very  close  relation  to  the 
emotions,  morals,  esthetic  feelings,  to  social  instinct,  and 
to  sex.  The  feelings  of  reverence  and  awe,  and  the  con- 
sciousness of  the  infinite  in  man  are  vague,  but  are  the 
most  powerful  parts  of  his  nature. 

Religion  furnishes  the  only  pure  ideals  that  half  of  the 
world  has  access  to.  It  has  proved  an  intellectual  stimu- 
lus, and  roused  a  metaphysical  frame  of  mind  in  some  of 
the  most  vigorous  nations,  such  as  the  German  and  Scotch. 
It  leads  more  toward  refinement  of  Hfe  than  any  other 
agency.  It  stimulates  the  benevolent  and  altruistic  feel- 
ings, and  leads  to  their  practical  demonstrations;  it  fights 
vice  and  immorality;  it  seizes  on  the  best  that  is  in  man 
and  transforms  the  character. 

The  Advantages  of  College  Life.— College  Hfe  is  of 
the  greatest  possible  advantage  to  girls  in  many  ways: 
it  is  broadening  to  the  mind;  discipline  is  maintained,  and, 
at  the  same  time,  the  girl  is  thrown  on  her  own  resources; 
adequate  means  are  provided  for  developing  both  mind  and 
body  to  their  greatest  capacity. 

Whether  the  girl  comes  from  the  country,  a  country 
town  or  city,  her  social  group  is  comparatively  Hmited;  her 
world  is  very  httle  and  the  ego  is  very  large.  The  dis- 
cipHne  that  any  large  body  of  students  bring  to  bear 
on  the  conduct  and  behavior  of  the  individual  is  one  of 
the  important  advantages  of  a  coUege  training.  The 
insignificance  of  the  ego,  who  is  only  a  unit  in  this 
large  community,  is  quickly  impressed  on  the  gi'ay  matter 
of  the  brain,  and  the  rough  and  unpleasant  angles  are  soon 


HYGIENE  OF  MIND   AND   ITS  RELATION  TO  HEALTH     221 

smoothed  off.  This,  in  addition  to  the  discipline  afforded 
by  the  college  officers,  and  the  total  lack  of  discipline  is 
the  weakest  point  in  the  average  girl's  education.  To 
be  brought  into  intimate  relation  with  the  members  of  a 
large  and  educated  community  is  in  itself  a  Hberal  educa- 
tion. To  learn  to  respect  the  rights  and  the  opinions  of 
others,  to  perceive  that  any  given  subject  has  a  great  num- 
ber of  points  of  view,  is  attaining  toward  a  healthy  mental 
balance  that  will  make  the  woman  broader  minded,  more 
sympathetic,  more  companionable,  and  more  charitable 
in  her  views  of  life. 

In  addition  to  the  regular  college  curriculum  are  the 
opportunities  afforded,  not  only  to  special  students,  but 
to  the  entire  body  of  students,  for  a  Hberal  education  in 
music  and  art,  and  so  a  broad  foundation  for  general 
culture  is  laid  that  will  greatly  increase  the  opportunities 
for  pleasure  all  through  Hfe. 

So  that,  in  addition  to  the  actual  knowledge  acquired 
by  a  college  education,  there  are  also  the  advantages  of 
the  discipline  of  and  development  of  mind  and  body;  the 
knowledge  of  how  and  what  is  worth  whUe  to  study;  the 
power  to  study  and  solve  Hfe's  greatest  problems  for  her- 
self and  those  dependent  on  her;  the  firm  muscles,  the 
clear  brain,  the  steady  nerves,  the  power  of  judgment,  the 
control  of  the  will,  and  the  formation  of  character — on  all 
of  which  the  ultimate  happiness  and  success  in  hfe  depend. 

Dr.  Beard  gives  to  brain  workers  a  value  of  Hfe  of  four- 
teen years  above  the  average.  The  brain-working  classes 
are  less  apt  to  worry,  less  apprehensive  of  indefinite  evils, 
and  less  disposed  to  magnify  minute  trials  than  those  who 
Hve  by  the  labor  of  their  hands. 

Spinoza  says  that  every  advance  toward  perfection 
gives  us  happiness,  and  it  is  safe  to  say  that  the  buoyancy 
which  characterizes  contemporary  thought,  the  hopeful 
outlook  amidst  the  dangers  which  threaten  us,  the  sense 
of  the  added  cubit  to  the  man's  stature,  are  due  largely  to 
the  recognition  of  the  power  for  good  within  his  soul  of 
which  he  was  not  formerly  aware. 


222  PERSONAL  HYGIENE  FOR  WOMEN 

Balance  of  the  Mental  Faculties. — There  must  exist  a 
certain  balance  between  the  various  faculties  of  the  brain 
in  order  to  insure  sanity.  A  high  order  of  intelligence 
without  much  will,  or  keen  emotions  without  a  corres- 
ponding power  of  inhibition,  and  overmastering  will  and 
slight  moral  sense,  vivid  imagination  without  common 
sense,  intense  social  instinct  without  much  conscience, 
fervid  religious  instinct  without  much  sense  of  duty  or 
altruism,  must  invariably  produce  one-sided  and  unbal- 
anced individuals,  and  the  results  would  be  bad  for  society; 
and  too  many  of  these  one-sided  or  unbalanced  people 
would  impair  if  not  endanger  the  safety  of  the  State. 

Excessive  ambition,  misdirected  energy,  longing  for  the 
unattainable,  regret  for  the  unalterable,  anticipation  of 
future  unhappiness,  lack  of  a  sense  of  perspective,  fretting 
over  non-essentials,  indecision,  reopening  of  troublesome 
questions  already  settled,  avarice,  selfishness,  excessive 
emotions,  uncontrolled  passions,  and  the  actual  cultiva- 
tion of  the  melanchohc  state  are  some  of  the  causes  of 
mental  anguish  and  subsequent  physical  suffering. 

Well-balanced  mental  faculties  give  a  philosophic  view 
of  life;  guard  the  mental  and  hold  the  emotional  in  check; 
grasp  the  true  relationships  in  life,  and  view  it  in  the 
proper  perspective. 

The  Effect  of  the  Higher  Education  of  Women. — Nothing 
is  so  convincing  as  actual  experience  and  statistics;^  and 
nothing  is  so  broadening  to  the  mind  as  the  study  of 
history. 

Never  before  in  the  history  of  the  human  race  has  any 
such  large  body  of  young  women  been  given  the  edu- 
cational advantages  for  the  development  of  body  and 
mind  which  they  enjoy  to-day.  From  antiquity  there 
have  been  exceptional  women,  who  were  highly  educated 
and  cultured,  as  in  Alexandria,  Athens,  and  in  the  old 
European  universities,  but  up  to  the  present  day  any 
tendency  toward  the  education  of  the  masses  of  women 

*  "  Education  as  the  Controlling  Factor  in  the  Physical  Life  of 
Woman,"  Four  Epochs  of  Woman's  Life. 


HYGIENE  OF  MIND   AND   ITS  RELATION  TO  HEALTH     223 

has  been  looked  at  askance,  and  in  this  respect  the  position 
of  the  people  of  the  United  States  was  long  peculiarly 
provincial. 

To  two  men  belong  the  great  credit  and  honor  of  con- 
ceiving the  idea  of  a  liberal  college  education,  and  a  medi- 
cal college  training,  for  women  in  this  country. 

In  1865  Mathew  Vassar,  ''having  recognized  in  woman 
the  same  intellectual  constitution  as  in  man,"  founded  a 
college  for  women  only,  and  thus  gave  women  the  oppor- 
tunity for  the  same  education  that  young  men  enjoyed  at 
their  colleges. 

In  1850  the  Woman's  Medical  CoUege  of  Pennsylvania 
was  incorporated.  The  idea  of  establishing  a  college  for 
the  medical  education  of  women  originated  with  Dr. 
Bartholomew  Fussel,  of  Chester  County.  The  query  arose 
in  his  mind,  "  Why  should  women  not  have  the  same 
opportunities  in  Hfe  as  men?" 

Just  how  strong  the  public  sentiment  was  against  these 
movements,  and  the  leaders  of  the  opposition  comprised 
the  most  prominent  educators  and  physicians  of  the  day, 
and  what  impediments  they  placed  in  the  way,  it  is  now 
difficult  to  realize. 

The  opponents  of  the  higher  education  of  women  urged 
three  final  objections:  First,  women  were  mentally  in- 
capable of  receiving  the  same  kind  of  intellectual  educa- 
tion as  was  given  to  young  men  at  college.  Second,  they 
lacked  the  physical  endurance  to  bear  the  strain  of  mental 
work.  And,  third,  such  an  education  would  render  the 
young  woman  masculine — she  would  no  longer  be  willing 
to  look  after  the  ways  of  her  house,  her  natural  affections 
and  power  to  love  would  vanish,  she  would  become  unwil- 
ling to  marry  and  bear  children. 

Ex-President  EHot,  of  Harvard  University,  who  has  so 
long  been  the  great  educational  leader  in  this  country, 
in  his  paper  on  "The  Higher  Education  of  Women," 
says:  "During  the  past  thirty-five  years  three  distinct 
apprehensions  concerning  the  effect  of  the  higher  educa- 
tion of  women  seem  to  me  to  have  been  removed.    In  the 


224  PERSONAL  HYGIENE   FOR  WOMEN 

first  place,  there  was  a  perfectly  sincere  doubt  (because 
there  was  httle  experience  to  go  upon)  whether  young 
women  were  so  capable  as  young  men  of  receiving  what 
was  then  called  the  higher  education;  or,  in  other  words, 
whether  the  young  woman  had  the  capacity  to  master  by 
study  the  traditional  subjects  of  the  higher  education. 
That  doubt  has  been  completely  removed. 

"Secondly,  it  was  feared  that  if  the  young  women 
studied  in  the  colleges  three  or  four  years,  beginning 
at  about  eighteen  years  of  age,  that  such  study  would 
have  serious  effect  on  their  health  and  on  their  fitness 
for  their  natural  functions  in  after-life.  This  apprehen- 
sion was  felt  by  many  physicians  and  was  warmly  ex- 
pressed. For  a  whole  generation  we  have  been  trying 
the  experiment,  and  the  result  is  perfectly  clear.  These 
apprehensions  have  not  been  justified.  It  is  apparent 
that  young  women  can  do  much  mental  work  for  three 
or  four  years  between  the  age  of  eighteen  and  twenty- 
two,  not  only  without  impairing  their  physical  vigor, 
but  all  the  time  improving  it,  if  they  live  wisely  and  under 
right  conditions. 

"And  thirdly,  there  was  the  strong  apprehension  felt 
by  many  excellent  people,  lest  in  the  process  of  the 
higher  education  young  women  would  be  denatured. 
They  admitted  that  young  men  were  not  denatured  in 
any  way  by  the  higher  education  at  college,  but  they 
thought  that  there  was  a  serious  chance  that  young  women 
would  be  altered  in  their  feminine  nature  by  the  process 
of  education.  It  has  turned  out  that  a  young  woman 
who  studies  in  college,  from  the  age  of  eighteen  to  twenty- 
two,  is  no  more  altered  in  her  nature  than  a  young  man  is 
who  goes  through  a  similar  process.  It  takes  a  great  deal 
more  than  that  to  alter  the  nature  of  a  woman. 

"I  suppose  that  this  apprehension  was  based  on  the 
fact  that  women  seem,  to  men  at  least,  more  tender, 
fragile,  and  delicate  than  men,  and,  therefore,  more  liable 
to  be  bruised  or  coarsened  than  men;  it  was  feared  that 
the  kind  of  public  life,  so  to  speak,  in  large  groups  would 


HYGIENE   OF  MIND  AND   ITS  EELATION  TO  HEALTH     225 

have  some  tendency  to  deprive  them  of  their  natural 
delicacy,  refinement,  and  tenderness.  It  has  not  turned 
out  so,  and  everybody  recognizes  that  it  has  not  turned 
out  so." 

When  higher  education,  the  professions,  and  industrial 
pursuits  are  all  unquestioningly  thrown  open  to  women, 
then  it  can  be  reasonably  supposed  that  they  will  come 
to  possess  those  traits  of  mind — judicial,  logical,  creative, 
etc.,  now  generally  considered  as  masculine  traits,  and 
they  will  not  only  be  more  attractive  and  companionable 
for  their  husbands,  but  will  be  far  more  competent 
teachers  for  their  children,  their  enlarged  range  of  thought 
and  vision  inspiring  greater  confidence  in  their  sons, 
and  stimulating  higher  ideals  in  both  sons  and  daughters. 

The  Environment. — ^As  we  have  seen,  the  brain 
registers  every  impression  from  within  and  from  without; 
if  the  impressions  are  those  of  discomfort,  gloom,  darkness, 
ughness,  those  things,  being  inharmonious  to  the  con- 
stitutional working  of  the  brain,  do  harm  and  tend  to  set 
up  bad  habits.  First,  the  body  must  be  healthy,  and 
the  environment  good  in  order  to  insure  a  healthy,  vigorous 
mentality.  Too  much  thought  and  care  cannot  be  given 
to  the  environment  of  the  child,  youth,  and  adult. 

Careful  attention  must  be  given  to  the  toilet.  The 
quahty  and  condition  of  the  underhnen,  the  cut  and  fit 
of  the  clothes,  aU  tell  on  the  mind.  It  has  been  said  that 
a  man  tries  to  five  up  to  his  clothes;  hence,  the  uniform 
of  the  soldier  and  the  cassock  of  the  priest.  Clothes  are 
not  only  an  index  of  the  character,  but  they  help  to  make 
it.  The  clothing  that  comes  into  intimate  contact  with 
our  bodies  has  a  soothing  or  irritating  effect  upon  the 
mind.  It  has  also  been  said  that  for  a  woman  to  know 
that  she  was  properly  dressed  had  a  soothing  influence 
on  the  mind,  second  only  to  that  of  religion  itself. 

In  the  evening,  laying  aside  the  business  suit  of  the 
day  with  all  the  anxieties  and  dust  of  toil,  and  replacing 
it  by  a  tasteful  house-gown,  brings  a  sense  of  freshness 
that  brightens  the  mind  and  stimulates  the  appetite. 

15 


226  PERSONAL  HYGIENE   FOR  WOMEN 

The  clothing  should  always  be  suitable  to  the  employment, 
to  the  purse,  and  to  the  surroundings,  or  good  taste  is 
violated,  and,  again  there  is  an  unhealthy  reaction  on  the 
mind. 

To  live  in  a  gloomy  house,  with  a  dull  ugly  wall-papers, 
and  no  sunshine  entering  the  room,  may  produce  in  their 
inhabitants  want  of  appetite,  interfere  with  nutrition, 
make  them  gloomy,  unhappy,  and  hard  to  live  with. 
While  esthetic  surroundings  render  life  happier,  brighter, 
and  higher. 

If  one  cannot  afford  expensive  paintings  to  hang  on  her 
walls,  she  can  select  photographs  of  the  old  masters, 
neatly  framed,  which,  placed  in  harmonious  surroundings, 
elevate  the  mind,  cause  a  love  of  the  beautiful,  develop 
the  taste,  and  lay  the  foundation  for  a  broad  culture 
that  will  increase  the  enjoyment  of  nature  as  well  as  of 
art. 

The  Choice  of  Friends. — We  have  seen  that  the  impres- 
sions conveyed  to  the  brain-cells  leave  a  fixed  registration 
and  are  indehbly  stamped  there.  These  may  be  called 
the  sensitive  plates  of  the  mind,  and  it  is  because  of  this 
writing  on  the  brain  that  the  selection  of  our  friends  and 
associates  is  a  matter  of  such  vital  importance. 

The  subconscious  mind,  of  which  we  hear  so  much  to- 
day, does  not  originate  thought;  it  can  only  elaborate 
and  develop  it,  and  the  most  important  fact  which  has 
as  yet  been  discovered  in  regard  to  the  subconscious  mind 
is  that  it  is  suggestible;  that  is,  it  is  subject  to  moral 
influence  and  direction.  A  few  words  of  commendation 
and  praise  brighten  the  whole  day;  if  we  can  forget  our 
pain  for  a  little  while,  it  is  apt  to  cease. 

All  our  greatest  intellectual  leaders,  from  time  immem- 
orial, have  been  unanimous  in  their  teachings  that  one 
of  the  most  important  elements  in  the  molding  of  the 
mind  and  character  was  the  nature  of  our  friendships. 
Tennyson  says,  " I  am  a  part  of  all  that  I  have  met."  "A 
man's  friendships  shape  his  life  more  than  aught  else,  or 
more  than  all  else."     The  immortal  bard  puts  it,    "It 


HYGIENE   OF  MIND   AND   ITS   RELATION  TO  HEALTH     227 

is  certain  that  either  wise  bearing  or  ignorant  carriage  is 
caught,  as  men  take  disease  of  one  another;  therefore, 
let  men  take  heed  of  their  company."  And  again,  "  'T  is 
meet  that  noble  minds  keep  ever  with  their  hke,  for  who 
so  firm  that  cannot  be  seduced?" 

Certain  requirements  and  standards  should  be  met, 
and  the  girl  or  woman  should  be  sure  that  the  individual, 
whether  man  or  woman,  comes  up  to  the  standards  of 
her  own  clan. 

A  friend  should  be  congenial,  with  similar  tastes,  oppor- 
tunities, and  training;  frank  in  criticism,  yet  sympathetic 
in  spirit;  loyal  and  staunch  in  adversity,  and  one  who 
disseminates  an  atmosphere  which  is  broadening,  elevat- 
ing, and  uphfting.  Such  a  friend  is  to  be  desired  and  to 
be  sought  after. 

Literature. — Not  one  of  the  least  of  the  great  molding 
influences  on  the  mind  and  the  social  life  of  to-day  is  its 
literature,  and  the  form  of  this  which  reaches  the  greatest 
masses  of  the  people  are  the  daily  press,  the  hterary 
magazines,  and  the  modem  novel.  It  is  scarcely  pos- 
sible for  the  young  to  conceive  the  great  impression 
which  is  made  on  the  mind  and  character  by  the  kind 
of  books  which  they  read.  Carlyle  said,  "  We  cannot 
look  however  imperfectly  upon  a  great  man  without 
gaining  something  from  him."  And  to  this  statement 
might  well  be  added,  it  is  impossible  for  the  mind  to  be 
brought  into  intimate  contact  with  the  lives  of  dissolute 
men  and  women,  so  vividly  portrayed  in  many  of  the 
novels  of  the  day,  without  being  smirched  by  it.  It  is 
no  more  safe  to  read  such  a  class  of  books,  hoping  to 
escape  contamination,  than  it  would  be  to  live  in  the 
malarial  districts  of  Africa,  and  hope  to  escape  contracting 
that  insidious  disease. 

However  limited  the  geniuses  may  be  in  our  immediate 
circle  of  friends,  each  of  us  may  have  for  her  most  intimate 
friends  the  greatest  geniuses  the  world  has  ever  known, 
and  have  them  at  their  best. 

Two  axioms  should  always  be  kept  in  mind — a  real  love 


228  PERSONAL  HYGIENE   FOR  WOMEN 

for  books  is  formed  in  early  life  or  not  at  all,  and  to  have 
books  for  friends  one  must  own  them,  have  them  on  her 
own  shelves,  to  take  down  and  put  up  at  will,  to  mark,  to 
compare,  and  study.  So  whatever  else  one  lacks,  she 
should  always  have  her  own  hbraiy,  even  if  it  is  a  Hmited 
one. 

Next  in  importance  to  the  recognition  of  good  reading 
must  necessarily  be  a  recognition  of  the  Hmitations  of  one's 
reading.  Whether  in  the  capacity  of  student,  housewife, 
mother,  or  business  woman,  the  time  that  can  be  devoted 
to  general  hterature  is  very  Hmited. 

A  careful  study  of  history  and  biography  should  always 
precede  fiction.  It  is  a  fundamental  part  of  a  Hberal  edu- 
cation to  know  something  of  the  world's  history,  and  the 
history  of  the  EngHsh  nation,  as  well  as  the  biographies  of 
the  men  and  women  who  were  such  important  factors  in 
making  its  various  epochs. 

This  should  be  followed  by  a  study  of  the  classics,  and 
that  education  has  not  been  hberal  which  has  not  included 
a  study  of  the  modem  classics.  German  Hterature  opens 
up  a  new  and  deHghtful  world.  A  study  of  the  classics 
forms  the  taste,  elevates  the  mind,  broadens  the  vision  and 
the  power  of  judgment,  and  it  is  a  profound  help  in  the 
formation  of  character.  After  such  reading  as  this,  who 
would  be  wilHng  to  spend  her  time  on  the  cheap  and  trashy 
novels  of  the  day. 

Good  modem  fiction  should  be  taken  up  as  a  recreation 
by  the  woman  whose  life  is  laborious,  its  questions  per- 
plexing, and  its  compHcations  tiresome;  in  other  words, 
after  the  woman  has  left  the  high-school  or  college  and  has 
entered  on  her  life's  vocation.  For  young  girls,  not  only 
is  too  much  time  apt  to  be  given  to  fiction  which  should  be 
devoted  to  other  and  more  important  matters,  but  it  is 
apt  to  do  much  harm  by  giving  them  a  wrong  impression 
of  life. 

The  Power  of  the  Will  or  Inhibition. — The  conduct  of 
mankind  is  chiefly  governed  by  the  emotions,  instincts, 
and  impulses.     Spencer  traces  aU  human  action  to  the 


HYGIENE  OF  MIND   AND   ITS  RELATION  TO  HEALTH     229 

desire  for  pleasure  in  the  large  and  philosopliic  sense  of  the 
term.  If  this  be  so,  then  the  education  and  hygiene  of  the 
emotions  and  impulses  must  be  of  the  very  highest  im- 
portance in  the  life  of  each  individual  and  in  the  social 
world.  The  question  arises,  and  it  is  all  important,  can 
those  inhibitory  centers  be  so  developed  in  youth,  and  so 
cultivated  in  Hfe,  that  they  can  act  as  antagonists  to  what 
is  morbid?  Can  they  be  used  as  direct  preventive  and 
curative  agencies  against  tendencies  and  impulses  which 
are  foolish  and  hurtful?  And  the  answer  of  educators,  as 
the  result  of  large  experience  and  observation,  is  emphatic- 
ally, yes. 

But  the  training,  to  be  efficient,  has  to  be  systematic, 
persistent,  and  along  well-defined  lines.  The  first  step 
in  this  training  must  be  the  strict  avoidance  of  all  that  has 
a  tendency  to  lower  the  standards  of  morality,  whether 
this  is  in  the  Hne  of  companions,  Hterature,  the  stage,  music, 
or  art.  To  do  otherwise  is  not  brave,  but  as  foolhardy 
as  it  would  be  for  a  weak  army  to  advance  against  a  power- 
ful foe;  it  means  annihilation  or  to  be  taken  prisoners 
of  war. 

To  overcome  obsessions  and  delusional  beliefs  by  vo- 
litional effort,  the  effort  should  be  made  to  direct  the 
mind  to  other  subjects  which  have  nothing  whatever  to 
do  with  the  obsession,  rather  than  to  make  a  direct  stand 
of  the  will  against  it,  since  the  will  may  put  forth  its  ut- 
most strength  in  the  way  of  direct  repression  of  the 
temptation  to  any  immoral  action,  and  may  entirely  fail, 
while,  by  directing  the  same  amount  of  force  in  chang- 
ing the  direction  of  thought,  complete  success  may  be 
attained. 

The  influence  of  the  will  upon  the  emotions  is  a  matter 
of  the  highest  importance  in  regard  to  the  direction  of  the 
current  of  thought  and  the  determination  of  actions. 
Control  your  passions;  govern  your  temper.  We  can  no 
more  avoid  feeling  mentally  hurt  than  we  can  feeling  phy- 
sical hurt,  but  we  have  exactly  the  same  power  of  the  with- 
drawal of  the  attention  from  the  mental  hurt  as  from  the 


230  PERSONAL  HYGIENE   FOR  WOMEN 

bodily  pain,  by  determinately  fixing  it  upon  some  other 
object. 

"I  am,  I  ought,  I  can,  I  will,"  are,  as  has  been  well 
said,  the  only  firm  foundation-stones  upon  which  we  can 
base  our  attempts  to  chmb  into  a  higher  sphere  of  exist- 
ence. The  first  impfies  a  faculty  of  introspection,  the 
second  a  moral  judgment,  the  third  a  consciousness  of 
freedom  to  act,  the  fourth  a  determination  to  exercise  that 
power. 

The  influence  of  the  will  on  the  conduct  is  first  auto- 
matic, through  previously  acquired  habits;  second,  through 
the  emotional  state,  and  third,  by  our  notions  of  right  and 
wrong.  In  the  fundamental  principles  of  Hving  must  be 
included  a  genuine  consideration  of  the  right  of  others. 
The  memory  is  an  automatic  reproduction  of  ideas,  the 
mechanism  of  recording  processes. 

The  education  of  the  will,  the  power  of  breasting  the 
current  of  the  desires,  and  doing  for  long  periods  of  time 
what  is  distasteful  and  painful,  all  tend  to  increase  the 
power  of  inhibition  and  strength  of  the  will.  Nothing 
that  is  learned  in  youth  is  really  so  valuable  as  the  power 
and  habit  of  self-restraint,  of  self-sacrifice,  of  energetic, 
continuous,  and  concentrated  effort. 

Seneca  claims  that  difficulties  strengthen  the  mind 
as  labor  does  the  body.  Plato  said,  that  "self-conquest 
is  the  greatest  of  all  the  victories." 

Character  fies  preeminently  in  the  sphere  of  the  will,  and 
anything  which  weakens  the  will  saps  the  worth  of  life  at 
aU  points.  The  strength  of  will  bears  not  only  on  char- 
acter, but  on  happiness  and  influence  as  well.  The  leader 
must  show  reserved  power,  and  make  it  plain  that  she  has 
herself  well  in  hand,  to  secure  confidence.  "  Will  makes 
men  giants." 

The  Effect  of  Mental  Attitude  on  the  Physical 
Health. — The  ordinary  operations  of  the  mind  have  little 
effect  on  the  physical  condition,  but  such  emotions  as  fear, 
worry,  anxiety,  grief,  despair,  anger,  hatred,  and  the  Hke 
depressing  emotions  act  directly  upon  the  muscular  and 


HYGIENE  OF  MIND   AND   ITS   RELATION  TO   HEALTH     231 

nervous  mechanisms,  profoundly  affecting  the  secretions 
and  the  excretions,  and  stamp  themselves  upon  the  very 
tissues  of  the  organism. 

Of  all  the  mental  attributes  the  emotions  are  the  most 
exhausting.  A  woman  can  spend  more  of  her  strength  in 
five  minutes  of  unnatural  excitement  than  in  a  clay  of  calm, 
steady  brain  work. 

A  perfect  temper  is  not  only  a  prime  requisite  for  a  club 
president,  but  for  every  man  and  woman  in  this  hard 
workaday  world,  with  its  fierce  competitions,  its  petty 
jealousies,  and  the  stiletto  practices  of  the  cowardly, 
and  it  is  one  of  the  greatest  preventives  of  indigestion, 
insomnia,  and  nervous  prostration. 

Forget  your  gTievances.  Every  time  that  one  repeats 
them  to  herself  or  to  a  friend  she  lives  them  over  again, 
and  the  original  trouble  was  but  the  merest  moiety  of 
suffering  compared  to  a  wound  torn  open  afresh  every  day. 
To  cherish  a  vindictive  spirit  does  a  vast  amount  of  injury 
to  the  possessor  of  that  spirit.  In  view  of  the  facts  of 
the  beneficial  effects  of  fighting  upon  small  boys,  and  that 
the  combative  propensities  of  the  Irish  peasant  commonly 
evaporates  with  his  shiUelagh,  it  would  seem  commendable 
to  introduce  boxing  matches  among  women  as  a  way  to 
settle  their  differences. 

From  the  standpoint  of  health,  the  intense  excitement 
attendant  on  playing  for  high  stakes,  the  loss  of  sleep,  the 
unnatural  Hfe,  the  loss  of  money  that  one  can  iU  afford  to 
lose,  must  eventually  lead  to  a  serious  if  not  to  a  fatal 
breakdown. 

It  is  not  the  natural  and  reasonable  intellectual  work 
that  injures  the  brain,  but  the  various  emotions — ambi- 
tion, anxiety,  disappointment,  the  hopes  and  fears,  the 
loves  and  hatreds  of  our  fives — that  w^ear  out  the  nervous 
system  and  endanger  the  balance  of  the  brain. 

Powerful  emotion  is  Hke  concentration  attended  with 
dissociation,  it  occupies  the  mind  to  the  exclusion  of  all 
else,  even  to  the  dictates  of  self-preservation  and  reason. 


232  PERSONAL  HYGIENE   FOR  WOMEN 

The  will  is  more  or  less  suspended  and  held  in  abeyance 
during  the  emotional  states. 

The  too  great  concentration  of  the  attention  on  one's 
business  or  occupation  is  a  self-indulgence  that  often 
ignores  the  importance  of  the  Hghter  side  of  life  and  the 
legitimate  claims  of  family  and  friends. 

Less  ambition  and  more  philosophy  would  greatly 
lessen  the  number  of  cases  of  nervous  prostration  and 
aUied  neuroses.  All  of  one's  fortune  is  not  staked  on  one 
throw  of  the  dice;  if  the  woman  fails  in  one  direction,  there 
are  other  resources  left. 

Concentration  of  the  mind  on  the  physical  suffering 
leads  to  the  so-called  habits  in  disease;  there  may  have, 
in  the  first  place,  been  a  real  physical  cause.  For  example, 
in  case  of  injuiy  to  a  Hmb  followed  by  severe  pain  in  that 
member  it  has  happened  that  after  amputation  of  the 
limb  the  consciousness  of  pain  persisted  in  the  brain. 
In  the  functional  neuroses,  the  first  cause  may  have  been 
a  real  physical  one,  but  the  individual  becomes  so  self- 
centered,  it  is  with  difficulty  that  the  mind  can  be  with- 
drawn from  the  ego,  and  a  cure  can  only  be  effected  by 
supplanting  the  intense  egotism  by  new  interests. 

Medical  Hterature  contains  numerous  observations  of 
ailment  caused  by  fright,  and  even  of  death  itself  so 
caused.  It  is  not  uncommon  for  medical  students  to  con- 
tract the  disease  about  which  they  are  studying.  In  the 
old  small-pox  epidemics  it  was  a  very  generally  observed 
fact  that  those  who  feared  contracting  the  disease  were 
the  most  apt  to  get  it.  The  reason  is  very  easily  explained 
— fear  so  suppressed  the  functional  activities  of  circulation 
and  nutrition,  as  to  predispose  the  individual  to  take  any 
disease  to  which  she  was  exposed. 

Autosuggestion  is  the  predominant  element  in  the  con- 
centration of  the  thought  on  one  particular  subject,  and 
of  the  narrowing  of  the  perspective  to  a  single  point  of 
view. 

Prolonged  anxiety  or  grief  will  cause  an  emaciation, 
second  only  to  that  of  tuberculosis  itself,  by  the  depression 


HYGIENE  OF  MIND   AND   ITS   RELATION  TO   HEALTH     233 

of  the  heart's  action  and  the  circulation,  the  loss  of  ap- 
petite, the  interference  with  nutrition,  and  the  loss  of 
sleep. 

Worry  is,  as  we  have  seen,  in  the  first  instance  most 
frequently  bred  of  exhaustion,  but,  if  indulged  in,  it  readily 
becomes  a  fixed  habit,  and  the  mind  rapidly  settles  into  a 
state  of  fixed  gloom. 

Worry  is  a  type  of  fear.  It  is  a  futile  regret  over  past 
mistakes  and  the  miserable  forecasting  of  the  future. 
It  has  been  called  the  great  shortener  of  hfe  under  civiliza- 
tion— of  all  forms  the  financial  one  is  the  most  frequent 
and,  for  ordinary  minds,  the  most  distressing. 

Anxiety  and  the  anxious  frame  of  mind  is  in  readiness 
to  take  fright  in  connection  with  our  most  vulnerable 
points  on  all  occasions  of  apprehension  or  uncertainty. 
As  no  one's  future  can  be  clear  throughout,  there  is  never 
wanting  the  matter  of  anxiety  to  a  mind  susceptible  of 
this  state. 

It  is  a  significant  fact  that  our  asylums  are  recruited 
from  the  classes  who  spend  their  fives  amid  narrow  monot- 
onous surroundings;  hence  the  large  proportion  of  women, 
especially  of  farmers'  wives,  whose  lives  are  probably  the 
most  narrow  and  the  most  monotonous.  From  this  result 
the  fixed  ideas,  the  obsessions,  and  all  the  absorbing 
egotism  of  insanity. 

With  a  variety  of  valuable  and  permanent  interests, 
the  mind  is  well  safeguarded  against  attacks  of  worry. 
The  overworked  woman  should  increase  her  recreations, 
leave  home  for  short  intervals,  travel,  and  have  entire 
rest  and  change  of  scene.  With  increased  vigor  of  body 
will  come  increased  power  of  the  will  and  the  capacity  to 
aboHsh  worry. 

Anger  fioods  the  brain  with  blood,  and  if  the  arteries  are 
brittle,  as  they  are  in  old  age,  and  the  individual  is  just 
as  old  as  her  arteries,  the  rise  in  arterial  tension  may 
result  in  the  rupture  of  a  blood-vessel,  and  the  subse- 
quent hemorrhage  into  the  brain  may  cause  an  attack  of 
apoplexy,   paralysis,  or  even  death.     Attacks  of  anger 


234  PERSONAL  HYGIENE   FOR  WOMEN 

hasten  the  deterioration  of  the  arteries;  in  this  way  anger 
has  been  known  to  cause  death. 

Every  violent  physical  sensation  will  react  on  the  lungs; 
every  powerful  normal  emotion,  whatever  its  cause,  will 
also  make  its  influence  felt  on  the  respiratory  functions. 
An  exercise  which  is  performed  with  tranquil  breathing  if 
the  mind  is  free  from  care,  quickly  produces  respiratory 
disturbances  if  the  mind  is  brooding  and  preoccupied. 
Those  who  have  acted  as  seconds  in  a  duel  to  men  accus- 
tomed to  the  use  of  the  sword  know  that  they  become 
breathless  in  the  duel  much  more  quickly  than  they  do  in 
the  fencing  school. 

Depressing  emotions  make  themselves  felt  in  the  respir- 
ations of  animals  as  well  as  of  man.  A  sensitive  horse, 
which  is  badly  used  at  its  work,  or  even  roughly  spoken  to, 
rapidly  becomes  breathless. 

The  dog  is  incomparably  less  swift  than  the  hare,  but 
is  able  to  catch  it;  the  fright  of  the  hunted  animal  disturbs 
its  breathing  and  robs  it  of  much  of  its  strength. 

In  fright  the  disorder  of  the  respiratory  movements 
destroys  the  reg-ularity  of  the  interchange  of  gases  which 
takes  place  in  the  lungs,  between  the  venous  blood  and 
the  atmospheric  air,  and  thus  profoundly  hinders  the 
function  of  the  aeration  of  the  blood. 

The  more  impressionable  the  subject,  the  more  easily 
do  the  emotions  influence  his  respiratory  actions.  Hence, 
the  superiority  in  certain  bodily  exercises  of  men  whose 
minds  are  calm  and  masters  of  themselves. 

Emotional  causes,  such  as  worry,  anxiety,  and  grief, 
as  well  as  the  more  tangible  physical  factors,  cause  soften- 
ing and  disease  of  the  tissues,  which  frequently  accounts 
for  the  arteriosclerosis  and  premature  seniHty.  Alienists 
have  long  found  abundant  evidence  that  abnormal  physical 
conditions  are  capable  of  producing  mental  diseases,  but 
the  reverse  is  quite  as  true. 

And  not  only  the  imagination,  but  the  intellect,  the 
emotions,  and  the  will  have  or  may  have  a  powerful  in- 
fluence over  the  sensations  and  organic  functions. 


HYGIENE   OF  MIND   AND   ITS  RELATION  TO   HEALTH     235 

It  is  not  only  profoundly  true  that  mental  attitude  has 
much  to  do  with  bodily  function,  capable  of  producing 
changes  in  its  nutrition  and  secretion,  but  we  may  go 
further  and  say  that  healthful  and  hopeful  habits  of 
thought  do  much  to  put  the  body  on  the  defensive  against 
the  assaults  of  disease. 

Mental  attitude  refers  not  to  the  will  or  the  emotions, 
but  to  the  mind  in  its  entirety.  The  trend  of  a  woman's 
thoughts,  the  use  she  makes  of  her  intellect,  the  strength 
of  the  volition,  the  sense  of  responsibility,  and  the  objects 
of  her  hfe  are  all  questions  that  have  a  distinct  bearing 
upon  the  bodily  functions  and  the  health  of  the  individual. 

A  Definite  Occupation  a  Physical  Necessity. — It  is 
now  generally  conceded  by  the  leading  sociologists  of  the 
day  that  women  who  are  not  engaged  in  the  duties  of 
maternity  need  the  same  intellectual  and  industrial  ac- 
tivities as  men.  Many  go  further,  and  it  is  their  opinion 
that  there  is  no  reason  for  excluding  women,  who  are  ful- 
filing  the  duties  of  maternity,  from  exercising  full  intel- 
lectual and  physical  activities  in  other  directions.  And 
the  proof  that  this  is  not  a  mere  theoretic  assumption 
is  to  be  found  in  the  fact  that  many  women  have  not  only 
given  birth  to  a  family  of  children,  but  have  successfully 
reared  them,  and,  in  addition,  have  been  eminent  in  other 
pursuits  and  callings.  Well-known  illustrations  of  this 
fact  are  to  be  found  among  the  most  noted  sovereigns  that 
Europe  has  ever  had — Catherine  de  Medici,  Maria  Theresa, 
Catherine  II  of  Russia,  and  Queen  Victoria. 

Pleasure  seeking,  as  the  end  and  object  of  Hfe,  leads  to 
ennui,  disgust,  and  physical  and  mental  deterioration, 
while  the  slavery  of  housework,  the  childish  vanities,  and 
petty  cares  and  vexations  are  most  injurious  to  the  nervous 
system,  so  that  for  the  life  of  the  housewife  the  education 
preceding  it  should  be  broad ;  and  the  more  highly  educated 
the  woman  is,  so  much  the  more  effectually  can  she  free 
herself  from  attaching  too  much  importance  to  every  little 
detail,  and  so  neglecting  what  is  higher  and  more  import- 
ant, and  it  wiU  be  a  great  preventive  of  irritability  of 


236  PERSONAL   HYGIENE   FOR  WOMEN 

temper,  quarrelsomeness,  and  even  melancholia  and 
mental  derangement,  from  which  so  many  of  these  women 
suffer  in  consequence  of  the  monotony  of  their  lives. 

Every  girl  when  she  leaves  school,  which  she  should 
consider  the  very  alphabet  of  her  education,  should 
prepare  herself  for  some  definite  occupation,  just  as  her 
brother  does. 

Glouston,  in  answer  to  the  question  as  to  how  the 
powers  of  the  mind  can  best  be  developed,  conserved, 
and  made  the  best  use  of  for  life's  work,  says:  "It  is  a 
most  fortunate  thing,  if,  during  the  later  period  of  ado- 
lescence, an  occupation  in  life  has  been  selected  which 
really  suits  the  capacity  of  the  individual  and  goes  with 
his  innate  tendencies.  The  seriousness  and  the  settled- 
ness  of  the  Hfe  of  the  period,  with  the  bracing  of  eveiy 
nerve  and  sinew  to  do  the  work,  to  gain  a  reasonable 
position  in  society,  and  to  enjoy  a  fair  amount  of  happi- 
ness, is  in  itself  a  tonic  of  no  mean  value,  while  over- 
taxing of  body  and  mind  is  always  a  risk,  as  well  as  an 
ambition  which  overreaches  itself.  The  repressions  of 
woman's  life  in  civilized  society  constitute  one  of  her 
serious  strains  and  dangers.  The  life  and  conditions  of 
a  working  woman  who  has  six  or  seven  children  in  a  few 
years,  who  has  small  means,  and  but  Httle  help,  is  in  my 
judgment  the  very  hardest  of  any  human  being  in  our 
modern  social  system." 

Thomas^  thus  sums  up  his  views  as  to  the  evils  result- 
ing from  the  non-occupation  of  women  of  the  better 
classes.  "Human  nature  was  made  for  action;  and 
perhaps  the  most  distressing  and  disconcerting  situation 
which  confronts  it  is  to  be  played  on  by  the  stimulations 
without  the  abihty  to  functionate.  The  mere  super- 
inducing of  passivity,  as  in  the  extreme  case  of  solitary 
confinement,  is  sufficient  to  produce  insanity,  and  the 
emotion  of  dread  or  of  passive  fear  is  said  to  be  the  most 
painful  of  the  emotions,  because  there  is  no  possibility 
of  relief  by  action. 

i"Sex  and  Society." 


HYGIENE  OF  MIND   AND   ITS   RELATION  TO  HEALTH     237 

"  The  American  woman  of  the  better  class  has  superior 
rights  and  no  duties,  yet  she  is  worrying  herself  to  death; 
not  over  specific  troubles,  but  because  she  has  lost  her 
connection  with  reaHties.  Many  women,  more  energetic 
and  more  intelligent  than  their  husbands  or  brothers, 
have  no  more  serious  occupation  than  to  play  the  house 
cat,  with  or  without  ornament.  It  is  a  wonder  that  more 
of  them  do  not  lose  their  minds;  that  more  of  them  do 
not  break  with  the  system  entirely,  is  due  solely  to  the 
inhibitive  effect  of  early  habits  and  suggestions. 

"The  remedy  for  the  irregularity,  pettiness,  Ul  health, 
and  unserviceableness  of  modem  women  seems,  therefore, 
to  He  along  educational  hues.  Not  in  general  and  cultural 
lines  alone,  but  in  a  special  and  occupational  interest  and 
practice  for  women,  married  or  unmarried.  This  should 
preferably  be  gainful,  though  not  onerous  or  incessant. 
Normal  life  without  normal  stimulation  is  impossible, 
and  the  stimulation  best  suited  to  the  nervous  system  is 
some  form  of  interesting  work." 

The  Psychology  of  Success. — Success  has  been  defined 
as  the  accomphshment,  the  reahzation  of  what  has  been 
willed  or  wanted,  the  ripe  fruition  of  the  well-tended  tree. 
The  achievement  of  fame  or  fortune  is  what  the  world 
generally  regards  as  success. 

Before  entering  on  an  enterprise,  all  the  premises  in  the 
case  must  be  had  in  order  to  form  correct  judgments, 
otherwise  incomplete  and  imperfect  knowledge  of  the 
case  will  lead  to  error  in  judgment,  in  which  there 
could  be  said  to  be  "no  chance  of  failure,  it  was  a  cer- 
tainty." 

An  element  that  always  makes  for  success  is  to  be  able 
to  supply  a  want  of  the  public;  it  is  partly  a  question  of 
demand  and  supply.  It  is  sometimes  possible  to  create 
a  demand.  But,  as  a  rule,  success  is  the  fruition  of 
patience  and  weU-directed  energy. 

There  is  nothing  which  tends  so  much  to  the  success  of 
volitional  effort  as  the  confident  expectation  of  its  success, 
while  nothing  is  so  likely  to  induce  failure  as  the  appro- 


238  PERSONAL  HYGIENE   FOR   WOMEN 

hension  of  it.  Since  the  tendency  of  the  cheerful  and 
joyful  emotions  is  to  suggest  and  keep  aHve  the  favorable 
anticipations,  while  that  of  the  depressing  emotions  is 
to  bring  before  the  view  all  the  chances  of  failure,  the 
former  will  increase  the  power  of  volitional  effort  and 
the  latter  will  diminish  it. 

The  mental  condition  also  exerts  a  direct  influence 
upon  the  physical  powers,  through  the  organs  of  the 
circulation  and  of  the  respiration,  the  heart's  impulse  being 
more  vigorous  and  regular,  the  aeration  of  the  blood 
being  more  efficiently  performed,  in  the  former  of  these 
conditions  than  in  the  latter. 

Success  too  easily  won,  or  won  early  in  life,  may  reaUy 
be  a  cause  of  failure,  because,  having  been  once  achieved, 
the  individual  may  be  content  with  what  she  has  and 
not  proceed  to  higher  development.  And  so  a  very 
inferior  success  may  be  the  tomb  of  energy  and  the 
satisfied  goal  of  ambition,  instead  of  a  stimulus  to  higher 
things. 

Lack  of  success  may  also  be  caused  by  indulgence  or 
lack  of  courage,  the  individual  preferring  to  sail  along 
the  chartered  course  of  mediocrity  rather  than  to  strike 
out  a  new  path  for  herself,  involving  risk,  anxiety,  and 
endless  work. 

And  perhaps  jealousy  in  the  rank  and  file  of  the  lazy,  in- 
different, and  mediocre  far  more  often  impedes  effectually 
the  road  to  success  than  is  dreamed  of,  so  that  a  greater 
degree  of  secretiveness,  warding  off  the  scent,  of  the 
intentions,  the  aspirations,  and  the  methods  of  work,  untU 
the  object  shall  have  finally  been  achieved. 

Another  and  most  important  secret  of  success  is  to 
recognize  failure  as  only  a  stepping-stone  to  higher  things. 
Eggleston  says,  "  Persistent  people  begin  their  success 
where  others  end — in  failure." 

The  people  who  succeed  in  this  world  are  the  people 
who  get  up  and  look  around  for  the  circumstances  they 
want;  if  they  cannot  find  them,  make  them.  "Circum- 
stances,"   said  Napoleon,  "I  make  circumstances." 


HYGIENE  OF  MIND   AND   ITS  RELATION  TO  HEALTH     239 

There  are  four  mental  requisites  necessary  to  the 
achievement  of  success,  namely:  a  clear  view  of  the  end; 
a  judicious  indifference  to  the  sentiment  around  by  the 
sweeping  away  of  obstacles;  an  indomitable  energy; 
and  the  power  to  resist  the  temptation  to  rest  on  the 
soporific  plane  of  mediocrity. 


CHAPTER  VII 

DRESS  THE  FUNDAMENTAL  CAUSE  OF  WOMAN'S 
PHYSICAL  DETERIORATION 

The  History  of  Woman's  Dress;  the  Corset  in  History;  the 
Crusade  Against  the  Corset;  the  Influence  of  the  Corset  on  the  Female 
Body;  the  Curved  Front  Corset;  the  Relation  of  Corsets  to  Ab- 
dominal and  Pelvic  Disorders;  the  Effects  of  Corsets  on  the  Muscles; 
the  Straight  Front  Corset;  the  Abdominal  Corset;  the  Wearing  of 
Corsets  by  Yomig  Girls;  What  Style  of  Corset  is  the  Least  Injurious, 
the  Shoe;  the  Stockings;  the  Essential  Qualities  for  Winter  Under- 
clothing; the  Length  of  the  Walking  Skirt;  the  Winter  Street  Dress. 

A  CAREFUL  study  of  the  history  of  woman's  dress  affords 
a  forcible  demonstration  of  the  fact  that  the  fmidamental 
cause  of  the  inferior  physique  and  lowered  vitality  of 
the  modem  woman  of  civiHzation  is  to  be  found  in  not 
only  her  own,  but  also  in  her  female  ancestors'  unhygienic 
mode  of  dress  for  many  centuries. 

Study  the  physique  and  dress  of  the  ancient  Greeks, 
then  follow  the  history  of  dress  down  through  the  Middle 
Ages  and  the  Renaissance  to  the  present  time,  and,  if 
further  proof  be  needed,  visit,  as  has  been  done,  the 
savage  races  of  the  earth  to-day,  and  behold  women  of 
powerful  and  classic  physique  still  exist  in  lands  where 
the  body  is  not  molded  according  to  the  barbarous  decrees 
of  the  "modiste  of  fashion." 

The  History  of  Woman's  Dress. — The  history  of 
Greek  costume  is  for  the  most  part  free  from  what  is 
known  as  change  of  fashion,  for  the  reason  that  the  Greeks 
did  not  attempt  to  reconcile  the  two  opposite  principles 
of  covering,  and  at  the  same  time  displaying  the  figure; 
that  is  to  say,  of  cutting  the  dress  to  fit  the  body. 

The  dress  of  the  Greeks,  when  at  the  height  of  their 
civilization — and  that  of  the  Assyrians,  Egyptians,  and 

240 


PLATE   II 


■^^- 


r/  ^ 


Greek  costumes.     "  Queen  and  two  attendants.' 


CAUSE   OF  woman's  PHYSICAL  DETEEIORATION      241 

ancient  Romans  was  not  essentially  different — was  very 
simple.  It  often  consisted  of  a  simple  garment,  the  tunic, 
which  pleased  the  eye  by  the  gracefulness  of  its  drapery, 
and  at  the  same  time  was  comfortable  by  reason  of  its 
looseness. 

The  chief  and  indispensable  article  of  female  dress  was 
the  chiton,  or  tunic,  consisting  of  one  piece  of  material, 
sewed  together  in  the  form  of  a  sack,  open  at  top  and 
bottom,  in  height  reaching  from  the  neck  to  the  feet  of 
the  wearer,  and  in  width  equal  to  that  of  the  extended 
arms.  Within  this  stands  the  figure,  and  first  it  is  girt 
around  under  the  breasts  by  a  girdle,  to  keep  it  from 
falling;  next  the  upper  edges  are  fastened  together  on  the 
top  of  the  shoulders  by  a  brooch,  and  the  arms  are  either 
left  bare,  pressing  down  into  folds  at  each  side  the  masses 
of  material,  or  these  masses  may  be  gathered  around  each 
arm,  and  fastened  down  the  outside  with  buttons  and 
loops,  so  as  to  form  sleeves. 

To  secure  greater  warmth  on  the  breast  and  shoulders 
the  chiton  was  made  long  enough  to  be  doubled  back  at  the 
top,  and  this  part  reached  to  the  waist.  Underneath  the 
chiton  was  worn  a  band  of  cloth,  to  support  the  breasts, 
and,  in  addition  to  this,  a  cord  was  sometimes  crossed 
round  the  breasts  outside  the  chiton,  to  assist  either  in 
supporting  them  or  in  bringing  out  their  form.  Round  the 
loins  was  sometimes  worn  either  a  short  petticoat  of  thick 
woolen  stuff  or  a  sort  of  bathing  drawers,  such  as  acrobats 
wore.  This  was  all  of  the  essential  dress  for  indoor  wear. 
The  chiton  was  made  of  a  variety  of  fabrics,  though  gen- 
erally of  hnen. 

For  outdoor  wear  was  the  himation,  a  garment  also 
worn  by  men;  it  was  made  of  woolen  stuff  and  was  worn 
fike  a  plaid. 

The  chiton  and  himation,  as  above  described,  continued 
to  be  the  standard  dress  from  450  B.  C.  onward. 

The  hair  was  most  usually  worn  gathered  back  from  the 
temples,  and  fastened  in  a  knot  behind  by  hair-pins  of 
ivory  or  bone,  either  plain  or  mounted  with  gold. 
16 


242  PERSONAL  HYGIENE  FOR  WOMEN 

For  the  feet,  sandals  were  usually  worn,  in  exceptional 
cases  shoes,  and  for  hunting,  high  boots.  Gloves  were 
never  worn  by  the  Greeks,  except  to  protect  the  hands  in 
working. 

From  the  time  of  Pericles,  the  great  European  distinc- 
tion between  male  and  female  dress  consisted  in  the  length 
of  the  skirt,  old  men,  priests,  and  officials  being  allowed  the 
privilege  of  wearing  long  or  women's  skirts,  and  young 
girls  being  permitted  to  wear  the  short  or  man's  skirt. 
Among  the  Romans,  this  single  garment,  worn  by  both 
sexes,  was  called  the  toga. 

As  time  roUed  on,  this  loose  cord,  which  had  formed  the 
girdle,  was  reinforced  by  a  broad  belt  or  band  to  support 
the  breasts.  Among  the  Assyrians  this  belt  was  made  of 
stiffened  Unen  or  thin  metal;  the  Egyptians  wore  a  folded 
belt;  a  broad  belt  for  supporting  the  breasts  was  also  worn 
by  the  Roman  ladies.  But  whatever  the  material  used, 
this  stay-belt  does  not  show  any  signs  of  tight  laces  or  of 
vertical  ribs  of  iron  or  bone.  It  was,  however,  the  fore- 
runner of  "stays,"  and  when  the  moral  fiber  of  the  Greeks 
grew  lax,  the  courtesans  set  the  fashions,  and  dress  was 
used  to  display  rather  than  to  conceal  the  figure,  and,  in 
order  to  make  the  hips  more  prominent,  the  waist  was  con- 
stricted by  a  many-layered  belt.  At  the  same  time,  the 
use  of  cosemtics  was  introduced. 

The  Mediaeval  or  Middle  Ages. — From  the  end  of 
the  fifth  century  to  the  beginning  of  the  seventeenth  there 
was  a  singular  resemblance  in  many  marked  particulars 
between  the  dress  of  the  two  sexes.  It  now  became  the 
object  of  dress  in  both  sexes  not  merely  to  clothe  the 
person,  but  also  to  display  the  figure  and  adorn  it.  In 
the  temperate  climates  there  are  always  greater  changes  in 
fashion  than  in  the  very  hot  or  very  cold. 

Subjugation  by  the  Romans  in  the  first  centuries  of  the 
Christian  era  was  followed  by  a  general  conformity  to  their 
mode  of  dress,  so  that  the  Roman  dress  may  be  considered 
to  have  become  European. 

In  marked  contrast  to  the  loose,  flowing  robes  worn  by 


CAUSE   OF   woman's   PHYSICAL  DETERIORATION      243 

the  southern  nations  of  Europe  in  their  decadence  were 
the  short  skirts  and  jackets  clinging  to  the  Hmbs,  which 
were  worn  by  the  hardy  nations  of  the  North,  who  were 
given  to  constant  fighting  and  the  pursuit  of  the  chase. 
The  Norman  lords,  following  the  fashion  of  the  south, 
swept  about  in  long  tunics  and  flowing  robes. 

In  the  twelfth  century  the  Anglo-Saxon  women,  dressed 
in  their  loose  garments,  were  indebted  to  the  Norman 
ladies  for  the  introduction  of  ''stays,"  and  the  fashion  of 
tightly  lacing  the  body  with  a  robe,  laced  down  in  front 
in  order  to  show  its  undulations,  as  well  as  the  use  of  cos- 
metics. 

In  the  household  register  of  Eleanor,  Countess  of  Leices- 
ter, which  bears  the  date  of  May  24,  1265,  is  one  of  the 
earliest  places  in  which  the  word  corset  occurs.  The 
word  is  again  found  in  reference  to  the  wardrobe  of  Richard 
King  of  the  Normans,  and  Edward  his  son.  Corsets  were 
at  this  time  worn  by  men  as  weU  as  women. 

The  author  of  the  life  of  St.  Thais,  who  lived  in  the 
twelfth  centuiy,  teUs  us  that  the  French  were  so  tightly 
laced  that  they  could  bend  neither  their  bodies  nor  their 
arms. 

Peter  the  Great  wrote  that  the  robes  are  so  tightly 
stretched  over  the  body,  that  the  ladies  can  scarcely  breathe 
in  them,  and  often  suffer  very  great  pain  in  order  to  make 
their  bodies  slender. 

It  was  in  the  thirteenth  to  the  fourteenth  century  that 
the  last  trace  of  the  Roman  drapery  gradually  disappeared : 
the  women  adopted  for  the  most  part  the  robes  with  the 
tightly  fitting  corsage,  leaving  ordinarily  uncovered  the 
neck  and  the  skin  of  the  breast ;  this  closely  fitting  corsage 
was  closed  in  the  back  by  lacing. 

Boots  and  shoes  of  this  period  had  their  pointed  toes 
made  two  or  three  times  the  length  of  the  wearer's  foot. 
The  fashions  of  England  were  the  same  as  those  of  France, 
though  apparently  they  were  not  carried  to  quite  the  same 
excess  as  on  the  continent.  The  singular  aim  of  each  sex 
was  not  only  to  emulate  the  other  in  the  sumptuous  style 


244  PERSONAL  HYGIENE   FOR  WOMEN 

of  dress  and  its  profuse  adornment,  but  also  to  imitate  the 
form  and  fashion  of  the  other's  attire;  this  obtained  in  both 
countries. 

The  Renaissance. — In  the  sixteenth  century  a  distinct 
separation  between  ancient  and  modem  dress  took  place, 
and  our  present  fashions  took  their  origin  from  about  that 
time.  It  was  during  this  century  that  men  adopted  clothes 
closely  fitting  about  the  body,  overcoats  with  tight  sleeves, 
felt  hats  with  more  or  less  rigid  brims,  and  closed  boots 
or  shoes.  The  women  also  wore  their  dresses  tightly 
fitting  to  the  figure,  with  tight  sleeves,  low-crowned  hats, 
and  richly  trimmed  petticoats.  These  garments,  which 
differ  wholly  from  antiquity,  constitute,  as  it  were,  the 
common  type,  from  which  has  risen  the  endless  variety 
of  modern  male  and  female  dress. 

At  this  time  the  general  resemblance  between  the  cloth- 
ing of  the  two  sexes,  which  may  be  traced  to  the  earliest 
times,  became  decided.  After  the  accession  of  Queen 
Elizabeth  in  1558,  the  well-known  costume,  associated 
with  herself  from  about  the  middle  to  the  close  of  her  reign, 
gradually  became  established.  The  long-peaked  and  tight 
stomachers  of  the  ladies,  and  the  padded  quilted  doublets 
of  the  men — it  might  truthfully  be  said  that  each  garment 
was  a  parody  of  the  other. 

Ruffs  of  an  exaggerated  amplitude  and  of  a  painfully 
severe  stiffness  were  worn  by  both  sexes. 

At  the  beginning  of  the  seventeenth  century  the  dresses 
were  tight  at  the  waist,  but  begun  to  be  made  very  full 
around  the  hips,  by  means  of  large  padded  rolls,  which  were 
still  more  enlarged  by  a  monstrous  arrangement  of  padded 
whalebone  and  steel.  To  both  boots  and  shoes  high  heels 
were  added,  in  place  of  the  flat  heels  previously  worn. 

About  1710  the  hooped  petticoat  was  introduced,  and 
about  1740  they  obtained  enormous  dimensions. 

When  traced  to  their  original  sources,  we  find  that  all  of 
the  extremes  of  fashion  were  made  to  conceal  some  deform- 
ity of  the  figure,  or  to  give  to  a  part  of  it  undue  prominence, 
as  in  the  case  of  the  corset,  which  was  first  introduced  when 


CAUSE   OF  woman's   PHYSICAL   DETERIOKATION      245 

clothes  were  not  wanted  for  the  conceahnent  of  the  person, 
but  to  make  more  prominent  the  curves  and  undulations 
of  the  figure.  The  ruff  grew  out  of  a  scrofulous  complaint 
on  a  royal  neck;  the  hoop-skirt,  to  conceal  the  enceinte 
condition  of  a  French  queen. 

The  Corset  in  History. — Dr.  Bouvier  divided  into  five 
epochs  the  transformations  undergone  by  the  corset,  or 
by  that  part  of  the  clothing  which  took  its  place  from 
earliest  antiquity  to  1853. 

The  first  epoch  is  that  of  antiquity;  in  this,  as  we  have 
seen,  the  band  or  girdle,  which  was  worn  by  the  Greek 
and  Roman  ladies,  was  the  forerunner  of  the  corset. 

The  second  epoch  comprises  a  great  part  of  the  Middle 
Ages.  This  was  a  period  of  transition  which  partook  of 
the  styles  which  preceded  and  followed  it.  At  first  there 
was  an  abandonment  of  the  narrow  Roman  band,  and 
later  the  introduction  of  the  corsage  fitting  tightly  about 
the  body. 

The  third  epoch  embraces  the  end  of  the  Middle  Ages 
and  the  first  part  of  the  Renaissance,  which  was  marked 
by  the  general  adoption  of  robes  with  a  very  tightly  laced 
corsage. 

The  fourth  epoch  is  that  of  the  whaleboned  corset, 
which  extended  from  the  middle  of  the  sixteenth  century 
to  the  end  of  the  eighteenth. 

The  fifth  epoch  is  that  of  the  modem  corset. 

The  busk,  known  since  the  fourth  century,  was  intro- 
duced into  France  in  the  sixteenth  century;  men  also 
wore  busks  or  stomachers.  The  busk  relates  closely  to 
the  history  of  corsets.  The  middle  of  the  sixteenth 
century  is  the  epoch  of  transition  from  the  corsage  to  the 
whale-boned  waist,  which  constituted  a  sensible  approach 
to  the  modem  corset. 

We  find  that  the  reign  of  Queen  Elizabeth  was  marked 
by  the  first  use  of  the  whalebone  stays.  These  were  much 
affected  by  her  successor  James,  who  insisted  that  aU 
his  courtiers,  male  as  weU  as  female,  should  cultivate 
the  appearance  of  the  wasp. 


246  PERSONAL  HYGIENE   FOR  WOMEN 

The  corset  of  George  II,  represented  in  Hogarth's 
pictures,  is  said  to  have  been  one  of  the  most  harrowing 
forms  of  screw  torture.  We  are  told  that  the  doughty  war- 
riors of  Gustavus  Adolphus  wore  stays  almost  to  a  man. 

To  Catherine  de  Medici  is  generally  attributed  the 
introduction  of  the  closely  whaleboned  waist  into  France, 
and  the  corset  which  she  invented  resembled  in  more 
than  looks  that  instrument  of  torture — ''The  Machine 
Virgin  of  the  Inquisition."  This  corset  was  made  of  steel, 
and  was  as  inflexible  as  a  suit  of  armor,  and,  like  a  war- 
rior's breast-plate,  consisted  of  two  pieces.  It  opened 
longitudinally  by  hinges,  secured  by  a  hasp  and  pin, 
made  like  an  ordinary  box  fastening.  In  the  front  and 
back  a  rod  or  bar  of  steel  projected  in  a  curved  direction 
downward,  and  on  their  bars  depended  the  adjustment 
of  the  long-peaked  body  of  the  dresses  and  the  set  of  the 
skirt  behind.  During  the  forty  years  in  which  she  ruled 
at  court  a  thirteen-inch  waist  measure  became  the  accepted 
standard. 

Madame  de  S6vign6,  born  thirty  years  after  the  death 
of  Catherine  de  Medici,  formulated  the  axiom  which 
has  since  been  a  law  to  the  French  modiste,  "  Les  hommes 
ont  la  permission  d'etre  laid;  les  femmes  ne  I'ont  pas; 
aussi  n'en  est-il  aucune  qui  consente  a  I'etre." 

The  idea  of  the  waist  was  unfortunately  that  which 
concerned  the  execution.  Instead  of  being  adapted  to 
the  body  or  figure,  in  accordance  with  its  form,  to  bend 
with  its  movements,  as  the  supple  corsage  which  preceded 
it  had  done,  this  new  garment  became  an  inflexible  mold, 
which  distorted  the  natural  contours  and  imposed  upon 
them  a  conventional  mold,  and  prevented  the  least 
variation  of  size  or  situation  of  the  contained  organs, 
as  weU  as  their  continued  integrity  and  the  proper  per- 
formance of  their  functions. 

The  use  of  the  whaleboned  corset  prevailed  even  among 
infants  scarcely  out  of  their  swaddling  clothes.  This 
was  the  natural  consequence  of  the  pretended  necessity 
to  mold  the  human  form  in  order  to  obtain  beautiful  pro- 


CAUSE   OF   woman's   PHYSICAL  DETERIORATION      247 

portions,  to  reform  nature,  and  prevent  her  mistakes, 
and  one  could  never  take  too  much  care  to  obtain  such 
laudable  ends.  Mothers  would  have  been  considered 
culpably  indifferent  of  their  children  who  had  neglected 
these  first  indispensable  cares  for  the  regulation  of  the 
formation  of  their  bodies. 

The  Crusade  Against  the  Corset. — From  the  time  of 
Galen,  130  A.D,,  to  the  present  day,  in  spite  of  the  ana- 
themas hurled  against  it  by  the  state  and  medical  profes- 
sion, denouncing  this  great  injury  which  woman  does 
herself,  has  the  corset  still  prevailed. 

In  the  thirteenth  century,  Henry  III,  having  per- 
mitted its  use  for  some  time,  proclaimed  a  very  severe 
edict  against  the  wearing  of  corsets,  which  was  considered 
so  pernicious  to  the  health  of  women,  but  of  no  avail. 

In  the  fourteenth  century  an  edict  was  issued  by  the 
Emperor  Joseph  of  Austria,  forbidding  the  use  of  corsets 
in  aU  nunneries  and  places  where  girls  were  educated,  and 
caUing  upon  the  Church  to  aid  him,  threatening  excom- 
munication to  those  evil-disposed  damsels  who  should 
persist  in  operating  upon  their  waists.  The  CoUege  of 
Physicians  of  that  day  took  up  the  subject  with  activity 
and  zeal,  and  dissertations  upon  the  evils  of  tight  lacing 
were  scattered  broadcast. 

Professor  Virchow,  that  eminent  pathologist,  wrote, 
"  What  is  the  use  of  introducing  the  principles  and  appli- 
ances of  hygiene  into  the  huts  of  the  poor  and  ignorant, 
when  the  scions  of  wealth  and  pretended  intelligence, 
especially  of  the  gentler  sex,  show  their  contempt  of 
hygiene  by  their  dress  and  general  wearing  apparel.  In 
days  gone  by  I  have  battled  against  that  diabolical 
invention  called  the  corset,  but  this  crusade  has  been 
given  up  by  me  as  absolutely  futile." 

The  modem  hygienist  has  taken  the  stand  that,  since 
the  corset  cannot  be  suppressed,  it  must  be  reformed. 
About  1880,  for  the  first  time,  some  attention  began  to 
be  given  to  the  hygienic  consideration  of  the  style  of  the 
corset. 


248 


PERSONAL  HYGIENE   FOR  WOMEN 


The  Influence  of  the  Corset  on  the  Female  Body. — 

As  a  result  of  the  four  hundred  years  in  which  the  corset 
has  molded  the  plastic  form  of  woman,  she  has  become 
physically  so  degenerated  that  it  is  necessary  to  have 
recourse  to  the  artifices  of  the  modiste  in  order  to  have 
even  the  appearance  of  a  good  figure,  and  the  support 
afforded  by  the  corset  to  maintain  the  erect  position. 

The  modern  corsets,  made  of  one  piece,  can  be  classified 
in  three  categories,  according  to  the  region  of  the  body 


Fig.  13. — Normal  chest. 


Fig.  14. — Effects  of  tight  lacing 
on  bony  thorax. 


on  which  they  exert  the  greatest  pressure.  First,  the 
"curved  front"  corset,  enveloping  the  thorax  and 
abdomen,  but  making  the  strongest  compression  at  the 
base  of  the  thorax;  second,  the  "straight  front"  corset, 
enveloping  the  thorax  and  abdomen,  but  making  the 
strongest  pressure  upon  the  abdomen;  and  third,  the 
"abdominal  corset,"  only  embracing  the  abdomen,  and 
supporting  neither  the  breasts  nor  the  base  of  the  thorax. 


CAUSE  OF   woman's   PHYSICAL  DETERIORATION      249 

In  studying  the  effects  of  the  corset  on  the  body  they 
will  be  considered  in  this  order. 

The  Curved  Front  Corset. — The  corset  is  applied  to  the 
trunk  of  the  body,  consisting  of  the  thoracic  cavity,  a 
distensible  cage  containing  and  filled  by  the  heart  and 
lungs;  second,  the  abdominal  cavity,  whose  walls  are 
almost  wholly  composed  of  muscles,  and  containing  the 
Kver  and  the  entire  digestive  apparatus;  and  third,  the 
pelvic  cavity,  whose  walls  are  partly  bony  and  partly 
muscular. 

When  the  anterior  wall  of  the  body  is  forced  to  take 
the  shape  of  this  curved  corset,  it  is  pressed  back  toward 
the  vertebral  column,  and  even  when  the  corset  is  not 
laced  tightly,  there  is  always  more  or  less  constriction  of 
the  base  of  the  thorax,  so  that  a  serious  deformity  of  the 
lower  part  of  the  thorax  and  abdomen  is  produced;  instead 
of  the  normal  outward  curve  of  the  anterior  surface  of  the 
body,  with  its  most  prominent  part  in  the  region  of  the 
umbilicus,  there  results  a  broken  line  at  the  waist,  and 
an  obtuse  angle  is  formed  here,  pointing  outward.  This 
causes  a  marked  incurvation  of  the  lower  part  of  the 
chest  and  its  approach  toward  the  spinal  column,  with  a 
corresponding  flatness  of  the  chest  and  lessening  of  the 
respiratory  capacity  of  the  lungs,  and  the  action  of  the 
heart  is  seriously  interfered  with. 

The  chest  or  thorax  is  forced  into  the  shape  of  a  cone, 
the  lower  opening  is  narrowed,  and  its  walls  are  brought 
too  near  together.  The  lower  ribs  become  too  short,  and, 
if  the  corset  is  worn  early  in  life,  the  upper  ribs  become 
too  long;  and  the  thorax  as  a  whole  is  too  long. 

The  greatest  constriction  produced  by  the  coraet  occurs 
in  the  plane  extending  from  the  ninth  to  the  twelfth 
ribs,  which  corresponds  to  the  position  of  the  diaphragm, 
stomach,  and  fiver. 

Just  how  seriously  the  curved  corsets  interfered  with 
the  expansion  of  the  lungs  was  shown  in  a  paper  pub- 
fished  by  Dr.  Sargent  in  1889.  He  foimd  that  the  average 
lung  capacity  when  corsets  were  worn  was  one  hundred 


250 


PERSONAL  HYGIENE   FOR  WOMEN 


and  thirty-four  cubic  inches;  when  corsets  were  removed, 
the  lungs  showed  a  capacity  of  one  hundred  and  sixty- 
seven  cubic  inches — a  gain  of  thirty-three  cubic  inches; 
that  is,  corsets  crippled  the  lungs  to  the  extent  of  one- 
fifth  of  their  entire  capacity. 

Nature  endeavors  to  make  up  this  loss  by  the  increased 
rapidity  of  the  heart's  action  and  more  frequent  respira- 
tions, but  this  is  at  the  ex- 
pense of  greater  wear  and 
friction  of  the  machinery. 
Palpitation  and  shortness  of 
breath  follow,  and  the  woman 
is  obliged  to  give  up  all  active 
exercise. 

Through  this  failure  of  the 
suction  power  of  the  heart 
there  result  disproportionately 
larger  lower  limbs  and  an  ac- 
cumulation of  adipose  tissue 
below  the  waist.  This  condi- 
tion is  much  more  common  in 
women  than  in  men,  and  is 
due  to  the  lack  of  power  of 
the  heart  to  draw  the  blood 
back  from  the  lower  limbs 
against  the  force  of  gravity. 
Hence,  the  blood  tends  to  finger 
in  the  lower  extremities  and 
the  oxidation  of  the  tissues  is 
interfered  with. 
The  Relation  of  Corsets  to  Abdominal  and  Pelvic  Dis- 
orders.— By  the  constriction  of  the  lower  part  of  the 
thorax,  as  we  have  seen,  the  action  of  the  diaphragm  is 
very  greatly  impaired;  this  not  only  seriously  interferes 
with  its  respiratory  function,  but  with  digestion  as  weU, 
since,  by  the  active  contraction  of  the  diaphragm  in  in- 
spiration, it  presses  down  the  fiver  and  other  abdominal 
contents,  and  produces  a  powerful  massage  of  those  organs, 


Fig.  15. — Diagram  show- 
ing the  action  of  the  curved 
front  corset  (O'FolIowell). 


CAUSE   OF   woman's   PHYSICAL  DETERIORATION      251 

which  aids  in  the  digestion  of  food  and  in  the  unloading  of 
the  bowels,  and,  at  the  same  time,  the  pelvic  circulation  is 
interfered  with  and  pelvic  congestion  is  favored. 

The  direct  pressure  of  the  corset  upon  the  side  waUs 
of  the  chest  forces  the  ribs  in  upon  the  abdominal  contents; 
the  Hver  suffers  most  from  this,  and  not  only  does  the  Hver 
sometimes  actually  show  furrows  upon  its  surface  from 
the  pressure  of  the  ribs^  but,  in  the  postmortem  room 


Fig.  16. — Relation  of  bony  thorax  to  lungs,  heart,  liver,  and  stomach, 
with  artificial  outline  produced  by  corsets  (after  Gray). 

of  the  great  Vienna  Hospital  deep  grooves  upon  the 
liver  were  repeatedly  found  with  great  distorsions  of  the 
body  caused  by  the  corsets,  and,  in  a  few  instances,  the 
left  lobe  of  the  Hver  was  found  to  be  nearly  separated  from 
the  right. 

By  the  constriction  of  the  waist,  the  liver  and  all  the 
abdominal  contents  are  pushed  downward  below  their 
normal  position,  and  their  functions  are  greatly  inter- 
fered with.    The  effects  of  this  pressure  upon  the  stomach 


252  PERSONAL  HYGIENE   FOR  WOMEN 

are  most  disastrous,  and  cause  a  host  of  digestive  and  ner- 
vous troubles.  There  is  very  frequently  a  prolapsus  of 
the  kidneys;  the  right  one  is  more  frequently  prolapsed 
than  the  left,  owing  to  the  relation  of  the  right  kidney  to 
the  Hver. 

In  a  study  of  50  cases  Dr.  Gallant  found  that  in  90 
per  cent,  the  stomach  was  pushed  down  below  its  normal 
level,  and  in  80  per  cent,  there  was  prolapsus  of  the  right 
kidney. 

The  constriction  of  the  waist  crowds  the  small  intestines, 
with  the  accompanying  mesentery  and  colon,  into  the 
pelvis;  if  the  rectum  is  loaded  with  feces  and  the  bladder 
empty,  there  follows  an  anterior  displacement  of  the 
uterus;  if,  on  the  other  hand,  the  rectum  is  empty  and  the 
bladder  distended,  there  is  a  backward  displacement  of 
the  uterus.  In  very  many  of  these  cases  the  compression 
and  constriction  are  great  enough  to  interfere  with  and 
retard  the  peristaltic  action  of  the  intestines,  and  con- 
stipation is  produced. 

Gynecologists  are  unanimous  in  the  opinion  that  tight 
lacing  is  a  most  serious  impediment  to  the  development 
of  the  pelvic  organs,  and  is  a  prominent  factor  in  causing 
disease  of  these  organs.  Tight  lacing  displaces  the  uterus 
downward  from  two  to  three  inches,  and,  at  the  same  time, 
the  pelvic  floor  is  bulged  downward  from  two  and  one- 
half  to  three  inches  and  the  circulation  rendered  sluggish. 

When  there  is  no  interference  with  the  respiratory 
movements  the  uterus  rises  and  falls  with  every  breath, 
and  the  movements  of  the  uterus  promote  the  circulation 
of  the  blood  in  the  pelvis. 

A  high  corset  compresses  the  breasts,  and  so  interferes 
with  their  development.  The  low  corsets  of  the  present 
day  support  rather  than  compress  the  breasts. 

The  Effects  of  Corsets  on  the  Muscles. — In  the  back  the 
corset  forms  an  extended  plane  from  top  to  bottom, 
destined  to  support  the  posterior  part  of  the  thorax 
and  to  diminish  as  much  as  possible  the  size  and  pro- 
jection of  the  shoulder-blades.    This  compression  of  the 


CAUSE   OF   woman's  PHYSICAL  DETERIOEATION      253 

muscles  of  the  back  leads  to  their  atrophy,  and,  as  it  is 
their  fimction  to  hold  the  spinal  column  erect  and  to  ap- 
proximate the  shoulder-blades  to  the  thorax,  when  they 
become  atrophied  the  bony  parts  become  much  more 
salient.  Further,  the  corset,  in  weakening  the  muscles 
of  the  dorsal  region,  interferes  with  the  nomial  forvv"ard 
projection  of  the  chest,  and  so  leads  to  its  flatness. 

The  corset  atrophies  the  articulations  of  the  vertebral 
column,  produces  a  round  back,  an  inequahty  in  the  height 
of  the  hips  and  shoulders,  with  the  resulting  familiar 
awkward,  waddling  gait. 

When  the  healthy  skeleton  offers  to  the  muscles  of  the 
body  a  soHd  base  of  support,  the  action  of  the  muscles  of 
the  back  are  not  interfered  with,  there  is  nothing  to  prevent 
their  contraction,  and  the  body  is  held  erect.  With  a 
perfect  muscular  development,  the  shoulders  are  effaced, 
the  back  is  admirably  straight,  and  the  carriage  is  erect 
and  graceful. 

The  strong  compression  of  the  muscles  of  the  abdomen 
not  only  destroys  the  normal  contour  of  the  body,  but,  by 
the  atrophy  of  the  abdominal  muscles,  a  partial  paralysis 
is  caused,  and  so  the  support  which  should  be  afforded  the 
viscera  by  these  muscles  is  weakened,  and  a  prolapsus  of 
the  abdominal  contents  follows. 

It  will  be  seen  that  the  two  bony  cavities  of  the  body 
are  connected  in  the  back  by  means  of  the  vertebral  column 
and  are  not  immovably  fixed  in  relation  to  each  other,  but 
by  reason  of  the  flexibility  of  the  spinal  column,  they  can  be 
approximated  or  the  distance  extended.  The  suppleness 
which  results  from  this  mobility  corresponds  to  the  physio- 
logic needs,  and  constitutes  one  of  the  most  essential  con- 
ditions for  gracefulness  of  carriage. 

The  movements  of  extension  of  the  chest  are  rendered 
possible  by  the  action  of  the  muscles  of  the  back,  which 
hold  the  trunk  erect  and  extend  the  vertebral  column. 

When  the  corset  is  apphed,  the  compression  and  con- 
striction fix  aU  those  portions  of  the  muscles  at  and  below 
the  waist;  the  action  of  the  muscles  between  the  chest 


254  PERSONAL  HYGIENE   FOR  WOMEN 

and  pelvis  is  diminished  at  least  one-half,  so  that  these 
muscles  become  atrophied  from  disuse,  and  when  the 
corseted  woman  wishes  to  straighten  up  the  movement 
must  be  executed  by  the  entire  trunk. 


Sternum 


The  vertical  dotted  line 
indicates  the  straight 
muscles  of  the  an- 
terior surface  of  the 
trunk  shown  in  Fig. 
18. 


^Pelvis 


Fig.  17. — Skeleton  of  head  and  trunk  (O'Followell). 

Without  the  corset,  the  pelvis  remains  fixed  and 
furnishes  the  normal  base  of  support  for  the  thorax, 
which  gains  the  erect  position  through  the  action  of 
the  muscles  of  the  back  acting  on  the  vertebral  column. 


CAUSE  OF   woman's   PHYSICAL  DETERIORATION      255 

Whereas,  with  the  corset  on,  the  pelvis  is  immobilized, 
and  it  follows  the  movements  of  the  thorax.  The  move- 
ment of  extension  of  the  thorax,  instead  of  taking  place 
in  the  region  between  the  false  ribs  and  pelvis,  take 
place  at  the  hip-joints — the  vertebral  coluron  remains 
rigid,  it  takes  no  part  in  these  movements. 

Then,  as  a  result  of  the  incurvation  of  the  anterior 
surface  of  the  trunk,  there  is  an  interference  with  the 


Fig.  18. — Muscles  of  the  anterior  surface  of  the  triink  (O 'Folio well). 

movements  of  extension  of  the  spine  and  its  immobiliza- 
tion, which  causes  the  propulsion  forward  en  masse  of 
the  abdominal  contents.  The  anterior  portion  of  the 
chest  is  shortened,  and  an  exaggeration  of  the  sacro- 
lumbar  angle  is  produced. 

On  the  sides  of  the  body  lateral  flexion  of  the  trunk  is 
possible,  through  the  contraction  of  the  muscles  between 


256 


PERSONAL  HYGIENE   FOR  WOMEN 


the  chest  and  pelvis,  but  with  corsets  on  this  is  impossible. 
The  two  cavities  are  fixed  by  the  rigid  armature  which 
composes  the  corset.  This  not  only  prevents  the  lateral 
flexions  of  the  body,  but  also  causes  an  unnatural  depres- 
sion above  the  crests  of  the  ilium.  The  waist  is  con- 
stricted to  such  an  extent  that  the  woman  can  only 

fasten  her  corsets  in  front  by 
having  them  widely  separated 
in  the  back. 

All  these  conditions  cause 
a  complete  immobilization 
of  the  thorax  on  the  pelvis, 
so  that  the  movements  of 
the  upper  part  of  the  body 
are  characteristic  in  corseted 
women,  and  she  moves  all  in 
one  piece. 

The  Straight  Front  Corset. 
■ — This  corset,  when  worn 
loose,  is  a  great  improvement 
on  the  curved-front  corset. 
"When  properly  fitted,  all  the 
compression  comes  at  the 
hips  and  across  the  lower 
part  of  the  abdomen,  which 
is  Kf  ted  up,  and  the  waist-line 
is  increased  in  size.  This 
corset  has  for  its  base  of 
support  the  bony  pelvis,  and 
there  should  be  sufficient  space  to  easily  introduce  the 
hand  between  the  lower  part  of  the  thorax  and  the  corset. 
In  this  case  there  is  great  freedom  of  movement  of  the 
entire  chest  cavity,  so  that  respiration  is  not  nearly  so 
much  interfered  with  as  in  the  curved-front  corset,  and 
if  the  corset  is  properly  fitted,  the  lower  part  of  the 
abdomen  is  raised  together  with  the  contained  viscera, 
and,  indeed,  this  style  corset  is  prescribed  in  cases  of 
prolapsus  of  the  kidneys. 


Fig.  19. — Diagram  showing 
the  action  of  the  straight  front 
corset  (OTollowell). 


CAUSE   OF   woman's  PHYSICAL   DETERIORATION      257 

By  having  the  base  of  support  from  the  bony  pelvis,  the 
chest  is  left  free,  and  a  good  chest  expansion  and  its 
throwing  forward  is  favored,  and  at  the  same  time  an 
erect  carriage  is  secured. 

The  waist-Hne  runs  below  the  short  ribs,  which  lengthens 
the  waist,  producing  graceful  hues  without  compression. 

But  not  all  straight  front  corsets  fill  these  conditions. 
Unless  sufficiently  long  and  well  fitted  about  the  hips, 
they  may  fail  to  raise  and  support  the  abdomen,  and 
when  too  tightly  worn  may  press  too  strongly  upon  the 
abdomen  in  the  pretext  of  obliterating  it,  with  the  result 
that  it  is  placed  in  a  vice  from  before  back.  Pressed 
down,  the  intestines  find  a  means  of  escape  at  the  lower 
border  of  the  corset. 

The  front  of  the  corset  is  frequently  carried  too  high 
up,  and  does  not  leave  the  epigastric  region  sufficiently 
free.  The  corset  must  absolutely  not  be  thoracic,  and 
must  definitely  renounce  the  support  of  the  breasts, 
which  should  be  accomplished  when  necessary  by  an 
extra  bust  supporter.  The  long  straight  corset  im- 
mobilizes the  trunk  in  the  same  manner  as  the  curved 
front  corset. 

The  Abdominal  Corset. — In  1902  Madame  Gaches- 
Sarraute  proposed  to  abandon  the  thoracic  corset  and  to 
introduce  instead  the  abdominal  corset.  This  corset 
embraces  the  pelvis  without  compressing  it,  and  takes 
as  the  foundation  of  its  support  the  bony  girdle;  the  plan 
of  the  Hne  of  support  is  obfique,  and  inclined  forward 
in  such  a  way  that  there  can  be  no  compression. 

In  this  way  the  pressure,  instead  of  coming  from  above 
and  annuling  the  contractions  of  the  abdominal  muscles, 
comes  below  and  reinforces  their  action;  the  stomach 
resumes  its  normal  position,  and  is  supported  in  the  plane 
of  its  greater  curvature,  facilitating  its  functions,  so  that 
digestion  will  be  performed  under  the  most  favorable 
conditions. 

The  abdominal  corset  should  not  exceed  the  height  of 
the  false  pelvis,  should  have  as  the  base  of  support  the  bony 

17 


258 


PERSONAL  HYGIENE   FOR  WOMEN 


girdle  of  the  pelvis,  and  should  be  rectilinear  in  front 
and  very  slightly  curved  in  the  back  and  below.  The 
hips  should  be  simply  surrounded  and  their  projection 
preserved.     A  curve  which  follows  the  normal  sinuosity 

of  this  plane  joins  the  piece 
from  the  hips  with  that  of  the 
abdomen. 

The  part  corresponding  to 
the  back  must  be  sufficiently 
wide  and  free,  so  that  the  pos- 
terior borders  of  the  corset  will 
be  parallel  when  it  is  put  on, 
and  the  plane  preserved  for  the 
back  in  the  pieces  which  form 
the  corset.  This  garment  will 
be  adjusted  without  strain  in 
the  back,  and  it  will  embrace 
the  form  of  the  body  so  exactly 
that  it  can  be  put  on  without 
being  unlaced. 

The  frame  of  the  corset  must 
be  reduced  to  a  minimum — a 
rigid  busk  in  front  and  some 
whalebones  in  the  back;  the 
hips  remain  free,  and  a  slight, 
separate  brace  supports  the 
breasts. 

The  Wearing  of  Corsets 
by  Young  Girls. — The  greatest 
dangers  come  from  putting  cor- 
sets on  young  girls  who  are  still  growing  and  are  veiy 
imperfectly  developed,  and  later  by  an  undue  constric- 
tion of  the  lower  part  of  the  thorax  and  the  waist,  so 
that  the  development  of  the  entire  body  and  its  organs 
is  seriously  interfered  with  and  all  beauty  of  form  is 
prevented. 

The  muscles  of  the  back,  like  those  of  the  abdomen, 
are  prevented  from  their  full  development,  and,  later. 


Fig.  20. — ^The  abdominal  cor- 
set (O'Followell). 


CAUSE   OF   woman's   PHYSICAL  DETERIORATION      259 

in  their  action,  by  the  use  of  the  corset.  The  earlier  the 
corset  is  put  on,  the  more  pernicious  will  be  the  effects, 
because  during  the  period  of  growth  the  bony  frame- 
work is  more  pUable  and  delicate,  so  that  a  relative  slight 
compression  is  sufficient  to  make  an  indehble  impression 
upon  the  form.  Before  the  complete  development  of 
the  hips  and  the  entire  bony  framework  an  enormous 
amount  of  harm  is  done  by  the  wearing  of  corsets. 

In  early  youth  the  heart  lies  higher  than  in  the  adult. 
By  narrowing  the  intercostal  spaces,  the  heart  is  retained, 
as  it  were,  in  its  youthful  position;  in  the  adult  female 
the  heart  is  found  to  He  higher  than  in  the  male,  and 
the  contraction  of  the  space  in  which  the  heart  has  to 
play  is  one  of  the  causes  of  woman's  fainting,  and  it  is  also 
a  cause  of  organic  disease  of  the  heart. 

At  puberty,  when  the  girl  is  rapidly  increasing  in  stature, 
and  her  menses  begin  to  be  a  drain  on  the  system,  relentless 
custom  adds  the  compression  of  the  corset  and  long  skirts, 
suspended  from  tightly  drawn  bands  around  the  waist. 

The  spinal  column  at  this  age  lengthens  rapidly,  and 
it  should  carry  upward  all  the  viscera  attached  to  it; 
but,  owing  to  the  weight  of  the  clothing  and  the  com- 
pression at  the  waist,  this  normal  process  cannot  take 
place;  instead,  there  is  stretching  of  the  ligaments,  and 
the  viscera  are  prevented  from  rising  and  hang  at  a  level 
much  below  the  normal. 

A  girl  of  this  class  is  apt  to  be  slender,  with  under- 
sized hips,  and  has  a  characteristic  configuration  of  the 
anterior  surface  of  the  body,  a  hollowing  out  of  the  region 
over  the  stomach,  and  a  very  great  protrusion  of  the 
abdomen. 

The  uterus  remains  undeveloped  and  in  an  infantile 
state  until  near  the  approach  of  puberty,  when  it  develops 
rapidly,  and  continues  to  increase  in  size  until  the  normal 
size  is  attained — about  twenty  years  of  age.  By  the 
putting  on  of  corsets  the  free  mobility  of  the  uterus  and 
its  appendages  and  their  normal  development  are  inter- 
fered with. 


260  PERSONAL  HYGIENE   FOR  WOMEN 

This  period  of  growth  and  development  is  one  of  the 
greatest  importance  for  the  future  health  of  the  woman, 
both  physically  and  mentally,  and  the  most  intelligent  care 
should  be  given  the  girl  at  this  impressionable  age.  By 
putting  corsets  on  their  daughters  at  this  time,  mothers 
are  doing  them  a  very  great  wrong,  which  can  never  be 
entirely  atoned  for.  The  corset  prevents  growth,  develop- 
ment, and  the  participation  in  those  exercises  which  make 
for  physical  vigor  and  good  health.  To  the  well-developed 
girl  corsets  are  as  much  of  a  superfluity  as  crutches  would 
be,  and  nothing  but  the  prevaiHng  style  of  dress  causes 
girls  to  put  them  on. 

It  has  been  suggested  that  the  wearing  of  any  kind  of 
corsets  before  thirty  years  of  age  should  be  a  penal 
offense;  and  in  case  of  a  minor,  the  parents  should  be 
fined  from  one  hundred  to  one  thousand  dollars. 

As  regards  the  wearing  of  corsets  after  the  age  of  thirty, 
opinion  is  divided  into  three  clases — first,  those  who 
utterly  condemn  their  use:  second,  those  who  approve  of 
it;  and  third,  those  who  tolerate  the  wearing  of  corsets, 
but  only  under  the  condition  that  they  shall  cause  ab- 
solutely no  constriction. 

What  Style  of  Corset  is  the  Least  Injurious? — From 
the  nature  of  the  structure  of  the  chest  and  abdomen  and 
the  functions  of  respiration,  circulation,  digestion,  and 
the  pelvic  organs,  the  wearing  of  any  style  of  corset  must 
be  more  or  less  detrimental  to  the  health  and  vigor  of 
woman,  and  a  perfectly  developed  woman,  in  perfect 
health,  does  not  need  a  corset  if  she  lives  under  normal 
conditions  of  dress  and  life;  but  in  our  present  state  of 
civilization,  with  the  present  style  of  dress,  and  with  the 
very  imperfect  muscular  development,  women  in  and  past 
the  prime  of  life  may  wear  hygienic  corsets  without  any 
very  great  amount  of  injury. 

The  type  of  feminine  beauty  which  approaches  most 
nearly  the  ideal  is  that  of  harmony  of  proportions  and 
modulations  of  lines.  The  waist  proportions  of  the  Venus 
de  Milo  is  47.7  per  cent.,  while  that  of  the  Grecian  man  is 


CAUSE  OF  woman's  PHYSICAL  DETERIOKATION      261 

46.4  per  cent.  In  proportion  to  her  height  the  hips  of  the 
modem  woman  exceed  the  girth  of  those  of  a  man  by 
about  four  inches,  and  a  woman  of  the  same  height  as  a 
man  exceeds  in  hip  girth  by  six  inches.  If  the  muscles 
which  pass  from  the  thorax  to  the  pelvis  were  properly 
developed,  the  artistic  proportions  would  be  preserved,  and 
the  waist  of  the  woman  would  be  proportionately  larger 
than  those  of  a  man. 

The  ideal  figures  of  the  Greek  women  show  a  torso 
bounded  by  outward  curves,  softly  melting  into  one  an- 
other, until  the  broadest  part  is  reached  at  the  hips,  thence 
again  declining  to  the  feet.  The  line  from  the  armpit 
to  the  ankle  is  one  of  the  chief  Hues  of  beauty  in  sculpture, 
while  the  anterior  surface  of  the  body  should  present,  in 
the  median  Hne,  a  gentle  curve  from  the  upper  end  of  the 
breast-bone  to  the  brim  of  the  pelvis,  the  convexity  of  the 
curve  coming  about  the  umbiHcus.  An  inward  curve  of 
this  Hne  is  a  deformity  artificially  produced. 

In  order  that  the  corset  should  become  an  inoffensive 
garment  it  must  be  well  adapted  to  the  figure,  so  that  it 
shaU  not  embarrass  the  action  of  the  diaphragm  or  the 
vital  organs  or  the  movements  of  the  body. 

The  injurious  effects  of  wearing  the  curved  front  corset 
have  been  given,  and  this  style  of  corset  should  be  con- 
demned without  appeal,  since  its  use  is  dangerous  from 
every  point  of  view. 

The  straight  front  corset  is  much  less  injurious  than  the 
curved  front,  but  its  use  is  detrimental  to  health,  and 
prevents  the  free  movements  of  the  body,  so  that  the 
abdominal  corset  remains  the  only  one  which  is  perfectly 
safe  and  at  the  same  time  esthetic. 

The  chief  role  of  the  corset  must  be  to  sustain  the  cloth- 
ing and  to  prevent  the  constriction  of  the  fines  about  the 
waist  and  to  prevent  the  falling  of  the  viscera. 

This  can  only  be  accompfished  by  selecting  the  proper 
points  of  support  for  the  corset ;  this  is  in  the  lumbar  region 
of  the  spine  and  the  crest  of  the  bony  pelvis,  a  region  of 
several  centimeters  in  height.    Except  for  the  vertebral 


262  PERSONAL  HYGIENE   FOR  WOMEN 

column,  the  viscera  of  the  region  immediately  above  this 
have  no  bony  protection,  and  are  subject  to  the  greatest 
amount  of  constriction,  the  organs  being  piled  up  on  top 
of  each  other,  as  it  were,  and  thereby  suffer  very  great  dis- 
placement and  impairment  of  function,  while,  on  the  other 
hand,  the  solidity  of  the  bones  of  the  pelvis  permits  of 
their  use  as  a  base  of  support  for  the  corset,  as  well  as  for 
the  clothing. 

It  is  based  on  this  idea  that  the  hygienic  abdominal 
corsets  are  built,  and,  further,  this  style  of  corset  does  not 
sacrifice  the  normal  curve  of  the  anterior  surface  of  the 
body.  That  the  abdominal  corsets  do  not  support  the  bust 
is  no  detriment,  as  the  woman  with  very  fully  developed 
breasts  can  wear  a  bust  supporter,  entirely  separate  from 
the  corset,  and  in  those  pathologic  conditions  of  ptoses 
of  the  abdominal  contents — and  from  an  orthopedic  point 
of  view,  the  abdominal  corset  affords  an  excellent  solution. 

In  order  to  prevent  misfits,  all  corsets  should  be  made  to 
order;  the  measurements  must  be  taken  with  the  corsets 
removed.  The  corset  must  be  shaped  so  as  to  fit  exactly 
over  the  hips,  with  the  lower  parts  of  the  busks  very  slightly 
curved,  following  the  normal  curve  of  the  body.  The 
upper  part  of  the  corset  must  be  a  Httle  loose,  in  order  to 
permit  of  the  easy  movements  of  the  body.  Behind,  the 
line  of  the  corset  must  correspond  to  the  line  of  the  body, 
in  order  not  to  interfere  with  the  erection  of  the  body. 
In  front,  the  corset  overlaps  the  pubic  bones,  and  must 
be  tight  enough  to  give  the  abdominal  contents  some 
support. 

Instead  of  the  lacings  forming  two  "V's,"  the  lower  V, 
with  its  apex  at  the  waist-line,  and  the  longer  V  superim- 
posed on  top  of  this,  the  ensemble  of  the  lacings  to  be 
normal  must  form  only  one  V,  with  the  inferior  point 
very  elongated.  The  corset  is  too  tightly  laced  if,  when, 
with  the  strings  untied  at  the  waist,  the  upper  parts  of 
the  corset  separates. 

The  corset  should  be  put  on  with  the  lacings  wide  open, 
be  carefully  adjusted  in  the  proper  position,  and  fastened 


CAUSE  OF   woman's  PHYSICAL   DETERIORATION      263 

from  below  up.  After  the  stocking  supporters  have  been 
attached,  the  lower  part  of  the  corset  is  held  down  with  one 
hand,  while  the  other  hand  gently  draws  up  the  abdomen 
by  means  of  drawing  on  the  undervest,  or  slipping  the  hand 
within  the  corset;  in  this  way  the  abdominal  organs  are 
Hfted  up.  The  corset  is  then  laced  from  its  lowest  point 
to  the  waist-line,  and  from  the  top  to  the  waist-line,  in 
such  a  way  that  only  one  long  "V"  is  formed.  The  laces 
are  then  firmly  tied  and  slipped  in  under  the  corset. 

Corsets  that  sHp  up  are  probably  either  too  long  waisted, 
too  tight  over  the  fulness  of  the  hips,  or  there  is  not  suffi- 
cient curve  in  the  back  and  sides  at  the  waist-line.  High- 
backed  corsets  are  apt  to  make  the  woman  look  round 
shouldered,  while  a  low  back  gives  smoother  and  more 
desirable  lines. 

The  Shoe. — The  style  of  the  shoe  is  very  closely  related 
to  the  corset  in  the  amount  of  harm  it  is  capable  of  doing. 
Considering  the  fact  that  the  feet  form  the  base  of  sup- 
port for  the  entire  body,  and  that  on  their  condition 
depends  the  woman's  ability  to  take  a  sufficient  amount 
of  exercise  and  maintain  her  good  health,  surprisingly 
httle  attention  is  given  to  their  care. 

The  compression  of  the  foot  into  a  rigid  body,  not 
unUke  the  shoemaker's  last,  destroys  the  natural  relation 
of  the  parts,  prevents  the  growth,  interferes  with  the 
circulation,  compresses  the  nerves,  weakens  muscles  and 
ligaments  which  should  support  the  arch,  and  is  the  prohfic 
source  of  corns,  bunions,  weak  ankles,  and  "flat"  foot. 

But,  in  addition  to  the  direct  injuries  to  the  feet,  the 
excessive  elevation  of  the  heel  displaces  the  center  of 
gravity,  and  transfers  the  weight  of  the  body  for  the 
most  part  from  the  heel  to  the  line  of  union  of  the  instep 
with  the  toes,  a  series  of  joints  with  shallow  sockets 
not  formed  to  bear  the  brunt  of  the  body  weight.  In 
addition  to  which  the  equilibrium  of  the  body  can  only 
be  maintained  by  an  increase  of  the  natural  curves  of  the 
bony  framework,  with  the  resulting  increased  curvature 
forward  at  the  small  of  the  back,  is  an  increase    in  the 


264  PERSONAL  HYGIENE   FOR  WOMEN 

prominence  of  the  buttocks  and  abdomen.  This  tilting 
forward  of  the  pelvis  interferes  with  the  circulation  of  the 
pelvic  organs,  and  their  congestion  and  inflammation  follow. 

By  walking  around  in  her  bedroom  sHppers  any  one 
can  easily  convince  herself  of  the  greater  grip  that  the 
foot  has  on  the  floor  when  so  clad,  and  of  the  greater 
ease  and  sureness  in  walking;  this  is  chiefly  due  to  the 
greater  breadth  of  the  sole,  and  the  fact  that  the  shpper 
has  no  heel.  The  greater  firmness  of  men  on  their  feet 
on  shppery  pavements  is  doubtless  due  to  the  difference 
in  the  cut  of  the  shoe  and  the  lower  and  broader  heel. 

The  front  part  of  the  sole  of  the  shoe  must  be  so  de- 
signed that  the  great  toe  will  retain  its  normal  position 
and  rest  on  the  inner  border  of  the  sole.  In  many  shoes 
the  great  toe  is  forced  out  of  its  natural  position  toward 
the  middle  of  the  sole,  and  the  tip,  instead  of  pointing 
straight  forward,  is  thrust  toward  the  hne  of  the  sole. 
This  not  only  lessens  the  thrust  of  the  great  toe  as  it 
leaves  the  ground  in  walking,  but  also  leads  to  a  malforma- 
tion of  the  foot  and  ingrowing  toe-nails. 

The  soles  of  the  shoe  should  project  a  reasonable  distance 
beyond  the  uppers,  to  give  firmer  support  to  the  foot  and 
to  protect  the  soft  parts  in  walking. 

The  front  part  of  the  upper  leather  must  be  broad 
enough  for  the  free  movement  of  all  the  toes  in  walking 
and  in  springing;  when  it  does  not  give  room  enough 
for  the  toes  to  spread  outward  and  forward  in  walking, 
they  are  bent  on  themselves.  This  makes  the  descent 
of  hills  and  all  active  exercise  and  games  very  painful. 
Tight  upper  leather  is  also  productive  of  chilblains  and 
corns. 

The  shoe  should  be  shghtly  longer  than  the  foot  when 
the  entire  weight  of  the  body  is  placed  upon  it,  and 
sufficiently  broad  for  the  foot  to  spread  in  walking;  but,  at 
the  same  time,  the  shoe  must  fit  snugly  about  the  heel 
and  instep,  or  else  the  foot  will  slip  forward  in  walking, 
and  all  the  evil  effects  of  too  short  a  shoe  will  result. 

The  heel  of  the  shoe  must  be  broad  and  low.     High 


CAUSE  OF   woman's  PHYSICAL  DETERIORATION      265 

heels  force  the  foot  to  keep  perpetually  and  unnaturally 
on  the  stretch;  if  they  are  worn  in  early  youth,  they  may 
bring  about  permanent  deformity  of  the  skeleton  and  of 
the  foot.  Moreover,  the  high  heel  interferes  with  the 
natural  walk,  in  which  the  pressure  of  the  foot  on  the 
ground  passes  from  the  heel  to  the  toes.  The  high  heel 
requires  that  the  front  of  the  foot  should  be  set  down 
first  instead  of  the  heel.  The  result  is  an  awkward  trip- 
ping gait  and  a  short  step,  which  is  very  fatiguing.  This 
is  one  of  the  causes  for  woman's  frequent  dislike  for 
exercise  in  the  open  air,  such  as  walking,  mountaineering, 
games,  etc.,  and  so  the  general  health  is  affected. 

Again,  from  the  esthetic  point  of  view,  the  size  of  the 
foot  must  be  in  proportion  to  that  of  the  body.  Artists 
declare  that  every  foot  that  has  worn  a  shoe  is  deformed, 
and  so,  when  they  wish  to  make  a  study  of  the  foot,  they 
go  to  the  shores  of  Italy,  where  the  peasant  women  have 
never  worn  shoes. 

Paget's  description  of  a  perfect  female  foot  is  great 
breadth  and  fulness  of  instep,  a  well-marked  great  toe, 
a  long  second  toe,  projecting  a  Httle  beyond  the  great  toe, 
and  a  very  small  Kttle  toe. 

Since  the  feet  are  the  part  of  the  body  to  come  in  direct 
contact  with  the  greatest  amount  of  cold,  whether  on  the 
floor  of  the  house  or  the  pavement  of  the  street,  it  is  a 
matter  of  prime  importance  to  the  entire  body  that  they 
should  be  warmly  clad.  While  for  house  wear  and  in  the 
summer  time  a  French  kid  is  a  most  comfortable  shoe, 
for  street  wear  and  outdoor  exercise  in  cold  weather  a 
heavier  leather  with  thick  soles  is  requisite  as  a  protec- 
tion against  the  cold  and  damp. 

Rubbers  should  always  be  worn  when  the  pavements 
are  damp,  even  if  it  is  not  raining,  and  in  snow-storms 
and  very  heavy  rains  cloth  gaiters  should  be  worn  over  the 
shoes,  to  keep  the  ankles  dry,  and  later  to  protect  them 
from  the  wet  skirts. 

The  Stockings. — Great  care  must  be  taken  to  have 
the  foot  of  the  stockings  suflSciently  long  and  loose;   this 


266  PERSONAL  HYGIENE   FOR  WOMEN 

is  doubly  the  case  with  woolen  stockings,  which  are  apt 
to  shrink  so  much  in  the  wash.  A  too  tight  or  too  short 
a  foot  of  the  stocking  interferes  with  the  circulation  and 
causes  a  cold  foot,  and  when  the  stocking  foot  is  too 
short,  it  produces  the  same  deformities  that  too  short  a 
shoe  does. 

The  trouble  generally  begins  in  childhood;  mothers 
forget  in  buying  stockings  for  their  children  that  stockings 
shrink  in  the  laundry  and  that  children's  feet  grow. 
The  result  is  that  the  stocking-foot  is  apt  to  be  too  short 
before  it  is  worn  out,  and  so  the  toes  are  bent  or  cramped 
together,  and  there  is  the  starting-point  for  deformities 
of  the  feet  as  well  as  corns  and  bunions.  As  much  harm 
may  come  from  wearing  too  short  a  stocking-foot  as  too 
short  a  shoe. 

Again,  with  the  present  mode  of  wearing  the  stocking 
supporters  attached  to  the  corset,  or,  indeed,  one  of  the 
functions  of  the  stocking-supporters  may  be  said  to 
be  the  holding  down  of  the  corsets,  the  supporters  are 
shortened  for  this  purpose,  and  as  a  result  the  entire 
foot  of  the  stocking  is  pulled  on,  and  an  artificial  shorten- 
ing of  the  stocking-foot  is  produced;  and  this  point  must 
be  borne  in  mind  in  purchasing  stockings. 

Woolen  stockings  should  always  be  worn  during  the 
cold  weather.  Garters  should  never  be  worn  around  the 
leg,  whether  above  or  below  the  knees,  since,  in  order 
to  be  sufficiently  tight  to  hold  the  stockings  up,  they 
interfere  with  the  circulation  by  the  constriction  of  the 
leg,  and  so  cause  cold  feet  and  greatly  increase  the  trouble 
in  case  of  varicose  veins. 

The  Essential  Qualities  for  Winter  Underclothing. 
— These  are  that  the  clothing  must  be  light,  loose,  warm, 
and  equally  distributed  over  the  body.  From  the  hygienic 
standpoint,  the  underclothing  is  the  most  important  part 
of  the  dress. 

We  have  seen  that  much  of  the  energy  of  the  body  is 
spent  in  maintaining  its  normal  temperature,  and  that  the 
two  main  functions  of  the  skin  are  the  preservation  of  the 


CAUSE  OF  woman's  PHYSICAL  DETERIORATION      267 

normal  body  temperature  and  the  excretion  of  certain 
effete  matters  in  the  form  of  watery  vapors. 

In  the  temperate  zones  two  qualities  are  required  of 
underclothing — that  it  shall  prevent  the  too  rapid  radia- 
tion of  heat  from  the  body  and  that  it  shall  be  absorbent. 
No  material  is  warm  fer  se.  The  warmth  is  necessarily 
derived  from  the  body,  so  that  what  is  required  of  the 
underclothing  is  that  it  shall  confine  the  warmth  in  its 
meshes;  atmospheric  air  being  one  of  the  poorest  con- 
ductors of  heat,  the  material  should  be  so  constructed  as 
to  imprison  a  considerable  quantity  of  air  in  its  meshes. 

The  second  necessity  is  that  the  excrementitious  matters 
should  be  rapidly  absorbed,  as  they  are  being  constantly 
poured  out  from  the  skin,  so  that  the  material  must  be 
absorbent  in  the  highest  degree,  otherwise  the  fluids  re- 
main in  contact  with  the  skin  to  irritate  it,  and  the  atmos- 
pheric air  confined  between  the  undergarment  and  the 
skin  rapidly  becomes  surcharged  with  gases  and  moisture, 
and  so  acts  like  a  warm  jacket  around  the  skin.  Heat 
radiation  is  interfered  with  and  the  skin  becomes  extremely 
sensitive  to  changes  of  temperature  and  to  drafts. 

Wool  is  a  poor  conductor  of  heat  and  a  great  absorber 
of  water.  Its  powers  of  hygroscopic  absorption  is  at 
least  double  in  proportion  to  its  weight,  either  cotton  or 
linen,  and  this  property  is  an  important  one.  During 
perspiration  the  evaporation  from  the  surface  of  the  body 
is  necessary  to  reduce  the  heat  which  is  generated  by  ex- 
ercise. When  exercise  is  finished,  evapora.tion  still  goes 
on,  and,  if  unchecked,  to  such  an  extent  as  to  chill  the 
body.  If  dry  woolen  clothing  is  put  on  after  exertion,  the 
vapor  from  the  surface  of  the  body  is  condensed  in  the 
wool,  and  gives  out  again  the  large  amount  of  heat  which 
had  become  latent  when  the  water  was  vaporized,  and 
from  this  cause  alone  a  woolen  covering  feels  warm  during 
sweating.  In  the  case  of  tightly  woven  cotton  and  linen 
fabrics,  the  perspiration  passes  through  them,  and  evapor- 
ates from  the  external  surface  without  condensation;  the 
loss  of  heat  then  continues. 


268  PERSONAL  HYGIENE   FOR  WOMEN 

In  addition  to  this,  the  texture  of  wool  is  warmest  from 
its  poor  conducting  powers,  and  it  is  less  easily  penetrated 
by  cold  winds.  The  more  readily  material  conducts  heat, 
the  cooler  it  feels.  The  property  of  the  conduction  of  heat 
is  in  proportion  to  the  closeness  of  the  weave  and  the 
amount  of  air  which  it  contains.  For  this  reason  all 
loosely  woven  fabrics  feel  warmer  than  closely  woven  ones, 
on  the  same  principle  that  the  more  layers  of  clothing  there 
are,  the  more  layers  of  air  will  be  retained  between  them. 

The  recent  methods  of  weaving  cotton  and  linen  fabrics 
more  loosely  have  materially  reduced  their  general  defects 
as  underclothing  in  cold  weather,  and  if  cotton  or  linen  is 
worn  next  the  skin  it  must  be  so  woven  as  to  give  both 
thickness  and  porosity  to  the  fabric. 

For  the  majority  of  people,  during  the  wet  and  cold 
seasons  woolen  undergarments  are  the  best.  If  cotton  is 
worn,  it  must  be  loosely  woven,  so  that  it  may  entangle  a 
large  quantity  of  air  within  its  meshes. 

The  underclothing  should  fit  tolerably  closely  the  out- 
lines of  the  figure,  without  impeding  the  movements. 
Combination  undersuits,  which  reach  from  the  neck  to  the 
ankles,  are  the  best ;  the  weight  should  be  adapted  to  the 
season  of  the  year,  and  should  be  changed  with  the 
weather,  regardless  of  the  date  of  the  calendar. 

The  great  disadvantage  of  woolen  undergarments  is 
the  way  in  which  its  soft  fibers  shrink  in  washing,  and  after 
a  time  become  smaller,  harder,  and  less  absorbent.  To 
avoid  this,  the  greatest  care  must  be  exercised  in  the  wash. 
Woolen  fabrics  are  sometimes  very  irritating  to  the  skin, 
in  which  case  some  of  the  loosely  woven  cotton  or  linen 
fabrics  must  be  substituted.  In  the  choice  of  woolen 
undergarments  the  touch  is  the  best  guide;  there  should  be 
smoothness  and  great  softness  of  texture. 

In  very  cold  weather  the  combination  undersuit  worn 
in  the  house  should  be  reinforced  by  "equestrian  tights" 
for  outdoor  wear.  These  come  in  black  and  can  be  drawn 
on  over  the  shoes.  They  are  a  much  greater  protection 
against  the  cold  and  wind  than  a  flannel  skirt,  and  do  not 


CAUSE   OF   woman's  PHYSICAL   DETERIORATION      269 

possess  the  grave  objection  of  winding  about  the  legs  in 
walking  in  the  wind. 

Lack  of  proper  clothing  of  the  lower  part  of  the  body- 
is  beyond  question  one  of  the  chief  causes  of  the  great 
prevalence  of  pelvic  inflammation  and  of  Bright's  disease 
in  women. 

But  not  only  is  there  to  be  considered  the  danger  of 
laying  the  seeds  of  disease  from  going  out  into  the  cold  air 
while  the  body  is  too  lightly  clad,  but  also  that,  in  order 
to  maintain  the  normal  temperature  of  the  body  in  winter 
without  the  aid  of  warm  clothing,  requires  a  greater  ex- 
penditure of  nervous  energy,  which  in  turn  is  the  equival- 
ent of  a  large  amount  of  life  force.  It  is  not  only  impru- 
dent, but  most  injurious,  to  exhaust  unnecessarily  the 
powers,  of  the  body,  when  mere  mechanical  appliances, 
like  clothing,  wUl  obviate  this  continuous  expenditure  of 
vital  energy. 

Another  way  in  which  clothes  save  the  wear  and  tear  of 
the  body  is  by  diminishing  the  amount  of  heat  the  system 
must  produce  by  the  oxidation  of  the  elements  of  food. 
When  properly  clad,  there  is  less  loss  to  the  body  of  its 
heat,  and  consequently  there  is  less  food  needed  to  supply 
this  loss. 

The  Length  of  the  Walking  Skirt. — The  present  vogue 
of  having  the  walking  skirt  five  inches  from  the  ground  is 
an  excellent  one,  as  it  not  only  considerably  diminishes 
the  weight  of  the  skirt,  but  it  interferes  much  less  vnth  the 
forward  swing  of  the  leg  in  walking,  which  otherwise  has 
to  be  overcome  by  the  muscular  force  of  the  leg.  In  walk- 
ing, the  length  of  the  step  should  be  proportionate  to  the 
length  of  the  limb;  the  leg  is  carried  forward  by  the  un- 
conscious swing  at  the  hip. 

The  chief  exertion  in  walking  is  caused  by  the  raising 
of  the  foot  and  leg  to  the  point  at  which  it  goes  forward 
and  downward.  By  any  artificial  shortening  of  the  step, 
such  as  is  caused,  for  instance,  by  long  skirts,  it  requires 
much  more  muscular  effort  to  walk  the  same  distance. 
Besides  which,  there  is  the  additional  friction  of  the  skirts, 


270  PERSONAL  HYGIENE   FOR   WOMEN 

which  is  increased  by  the  slightest  wind;  this  has  been 
likened  to  the  process  of  eternally  walking  through  a  field 
of  long  grass. 

Another  most  important  reason  for  not  wearing  long 
dresses  on  the  street  is  that  they  stir  up  the  dust  and  col- 
lect microbes,  and  thus  contribute  materially  to  the  dis- 
semination of  the  germs  of  disease  and  subject  the  wearer 
and  her  family  to  the  risk  of  infection. 

The  question  of  clothing  takes  an  important  place  in 
the  hygiene  of  the  lungs.  All  clothing  may  be  approved 
which  is  sufficiently  warm,  and  which  allows  of  modifica- 
tions according  to  the  variations  in  the  temperature,  and 
does  not  hinder  the  movements  of  the  body,  and  particu- 
larly those  which  are  carried  out  by  the  respiratory  muscles. 
In  the  first  place,  it  is  very  important  that  the  muscles 
about  the  shoulders  should  have  perfect  freedom  of 
motion,  in  order  that  the  expansion  of  the  apices  of  the 
lungs  should  not  be  interfered  with.  Clothes  which  hang 
heavily  on  the  shoulders,  and  especially  those  which  grasp 
the  neck  tightly,  are  unsuitable.  Special  attention  must 
be  given  to  this  point  in  the  selection  of  winter  clothing. 

In  going  up  long  flights  of  stairs  furs  and  heavy  top  coats 
should  be  taken  off  and  carried  over  the  arm;  this  will 
prevent  much  shortness  of  breath  and  gasping  when  one 
reaches  the  top  of  many  flights. 

The  Winter  Street  Dress. — The  street  dress  for  winter 
should  be  warm  enough  to  prevent  a  feeling  of  chilliness, 
and  yet  be  light  enough  to  prevent  the  wearer  from  be- 
coming overheated  while  walking,  or  from  feeling  a  sense 
of  weight  of  the  clothing,  which  is  always  a  sign  of  being 
too  warmly  clad. 

For  outside  coats  impregnated  woolen  materials,  water- 
proof, but  at  the  same  time  porous,  are  the  best,  except 
in  very  heavy  rains.  A  storm  coat  of  some  kind  should 
complete  the  costume  for  rain  or  snow.  The  woman 
should  never  stay  indoors  on  account  of  very  cold  or  in- 
clement weather,  as  being  housed  up  and  the  lack  of  suffi- 
cient exercise  make  one  very  susceptible  to  the  very  sud- 
den changes  for  which  our  climate  is  so  notable. 


CHAPTER  VIII 

PHYSICAL  TRAINING  THE  KEY  TO  HEALTH  AND 
BEAUTY 

The  Ancient  Greeks  the  Most  Perfect  Type  of  Beauty;  the  Cause 
of  the  Inferior  Physique  of  American  Women;  the  Physical  Training 
of  the  Japanese  Women;  Improved  Physique  as  the  Result  of 
Physical  Training;  Increasing  Stature  and  Improved  Physique 
of  American  Men;  Report  of  the  Royal  Commission  of  Great  Britain 
on  Physical  Training;  Physical  Training  Among  the  Ancients;  the 
Influence  of  Physical  Training  on  the  Health  and  Life  of  the  Indi- 
vidual; the  Effect  of  Exercise  on  Brain  Development  and  Character; 
the  Physiology  and  Pathology  of  Exercise;  the  Relative  Proportions 
of  a  Perfect  Female  Form;  Table  of  Standard  Weights  for  Women; 
the  Muscular  System;  the  Benefits  of  Exercise;  Passive  Exercise; 
Massage;  the  Balance  and  Carriage  of  the  Body;  Common  Defects  in 
the  Carriage  of  the  Body;  the  Heart's  Need  of  Exercise;  the  Gym- 
nasium in  the  Campaign  against  Disease;  Gymnastic  versus  Ath- 
letic Training;  Exercise  after  Eating;  Effect  of  Brain  Fatigue  on 
Body  Fatigue,  and  vice  versa;  Marks  for  Physical  Efficiency; 
Advantages  Derived  from  Athletic  Sports;  Ethical  Value  of  Sports 
for  Women;  Forms  of  Athletic  Games  Best  Suited  to  Women. 

Physical  training  is  the  key  to  aU  beauty  of  form  and 
face  as  weU  as  grace  of  motion.  Beauty  without  health 
is  inconceivable. 

The  Greeks  were  the  devotees  of  the  beautiful,  and 
they  were  the  most  perfect  embodiments  of  health  and 
beauty  the  world  has  ever  seen.  Their  splendid  physique 
was  due  to  their  outdoor  life,  physical  training,  which 
began  in  childhood  and  youth,  and  was  systematically 
carried  on  throughout  Hfe,  their  public  baths,  and  their 
athletics,  sports  and  national  games.  Beauty  is  the  in- 
evitable corollary  of  health. 

And  the  Greek  artists  bequeathed  to  all  future  genera- 
tions a  legacy  of  untold  value,  using  the  men  and  women 
of  the  golden  age  of  Greece  as  the  prototypes  for  the  most 

271 


272  PERSONAL  HYGIENE  FOR  WOMAN 

beautiful  statues  which  the  world  has  ever  seen,  proving 
that  through  the  perfect  development  of  the  muscular 
system  alone  can  an  ideal  type  of  beauty  be  attained,  and 
these  statues  also  show  that  the  women  of  that  day  were 
the  physical  compeers  of  the  men. 

The  greatest  attention  to  the  physical  development  of 
her  citizens  was  given  in  Sparta.  Girls  and  young  women 
were  subjected  to  a  similar,  though  less  severe,  training 
than  men  and  boys.  It  included  running,  leaping,  wrest- 
ling, and  throwing  the  lance;  these  formed  the  favorite 
contests  in  the  national  games.  Xenophen  says:  "The 
Spartans  are  the  healthiest  of  all  the  Greeks,  and  among 
them  are  found  the  finest  men  and  the  handsomest  women 
in  Greece."  The  women  of  the  Teutonic  tribes  frequently 
accompanied  their  husbands  to  war,  and  exhibited  in- 
tances  of  the  most  daring  bravery. 

History,  as  well  as  these  magnificent  legacies  in  marble 
and  on  canvas,  teaches  us  that  no  greater  fallacy  could  be 
imagined  than  that  "we  are  women,  and  therefore  weak." 
On  the  contrary,  "  We  are  weak,  because  it  never  entered 
into  our  thoughts  that  we  might  be  strong/'  and  it  has 
been  repeatedly  proved  that  physical  deterioration  can  be 
overcome  by  exercise,  and  that  the  same  means  greatly 
increases  the  mental  capacity. 

In  savage  races  women  are  the  equal,  if  not  the  su- 
perior, of  the  men,  and  woman's  smallness  of  stature, 
physical  inferiority,  and  lessened  powers  of  endurance 
must  be  attributed  to  the  customs  of  civilized  society 
carried  on  for  hundreds  of  years. 

The  Cause  of  the  Inferior  Physique  of  American 
Women. — The  majority  of  American  girls  and  women  of 
the  present  day  have  undeveloped  muscles,  a  bad  carriage, 
an  impaired  digestion,  and  are  without  skill  in  outdoor 
games,  and  unable  to  ride,  row,  or  swim. 

From  the  measurements  of  twelve  hundred  boys  and 
girls.  Professor  Sargent  ascertained  that  at  the  age  of 
fifteen  years  boys  are  three-quarters  of  an  inch  taller  than 
girls,  but  that  the  mean  height  in  the  two  sexes  is  the  same, 


PHYSICAL  TRAINING  THE  KEY  TO  HEALTH         273 

and  that,  taking  the  sum  of  the  measurements  of  the  head, 
chest,  waist,  legs,  and  arms,  the  mean  total  was  equal  in 
boys  and  girls.  The  sum  of  these  measurements  is  regarded 
as  indicative  of  the  strength  of  the  individual,  but  that,  as 
a  matter  of  fact,  it  was  found  that  the  girls  did  not  com- 
pare favorably  with  the  boys  in  point  of  strength.  In 
capacity  of  lungs  the  girls  were  seventy  cubic  inches  be- 
hind the  boys,  and  that,  in  strength  of  the  expiratory 
muscles,  the  weakest  boy  was  stronger  than  the  average 
girl.  In  strength  of  back,  leg,  chest,  and  arms,  the  show- 
ing of  the  girls  was  a  little  better,  though  considerably 
below  what  it  should  have  been. 

At  twenty  years  of  age  the  man  was  found  to  be  five 
inches  taUer  and  twenty  pounds  heavier.  The  superiority 
of  the  male  in  strength  was  now  much  more  apparent  than 
at  an  earlier  age.  He  now  presented  ninety  cubic  inches 
greater  lung  capacity  and  one  hundred  and  forty-three 
pounds,  greater  strength  of  legs,  while  the  muscular  power 
of  the  arms  and  chest  was  more  than  double  that  of 
woman.  The  charts  showed  that  women  were  physically 
inferior  to  men  in  almost  every  particular. 

Dr.  Sargent  then  goes  on  to  say,  "The  principal  char- 
acteristics of  general  form  that  distinguish  civilized  women 
from  men  are  smaller  muscles,  sloping  shoulders,  broader 
hips,  and  shorter  legs.  The  smaller  muscles  and  the 
shorter  legs  may  be  said  to  be  embryonic,  while  the  super- 
ior breadth  of  the  hips  indicates  a  greater  evolutionary 
advancement  in  this  part  of  the  body  than  has  taken  place 
in  man.  The  constricted  waist  must  be  regarded  as  a 
deformity  artificially  produced.  When  the  hips  are  large 
in  the  male  or  female,  the  waist  wiU  naturally  be  larger  if 
the  muscles  which  connect  the  trunk  with  the  pelvis  have 
nothing  to  constrict  them.  Since  the  hips  of  women  are 
much  wider  than  those  of  men,  we  should  expect  to  find  the 
waist  proportionately  larger  in  women  than  in  men. 

In  close  antithesis  to  these  observations  of  Dr.  Sargent's 
on  the  physical  inferiority  of  American  women  to  men, 
it  is  both  interesting  and  instructive  to  note  those  of  Dr. 
18 


274  PERSONAL   HYGIENE   FOR   WOMEN 

Hancock  in  his  work  on  ''Physical  Training  for  Women 
by  Japanese  Methods." 

The  Physical  Training  of  the  Japanese  Women. — 

A  Japanese  woman  is  usually  the  peer  of  a  man  of  her  own 
race  who  is  of  the  same  age  and  height,  especially  when 
weights  are  about  equal.  This  is  due  to  the  fact  that  the 
Japanese  women  exercise  in  much  the  same  way  that  the 
men  do,  and  devote  fully  as  much  time  in  the  endeavor 
to  gain  strength. 

In  the  Japanese  system  of  bodily  training,  known  as 
jiu-jitsu,  it  is  considered  advisable  in  the  initial  stages  to 
have  boy  and  girl  contestants  as  nearly  equal  in  age  and 
height  as  possible.  The  girls  enter  the  arena  upon  equal 
terms  with  the  boys,  and  have  proved  their  fitness  to  do  so. 
Grown  men  and  women  practise  together;  other  conditions 
being  equal,  the  women  show  an  equal  amount  of  strength 
with  the  men. 

The  back  of  the  average  Anglo-Saxon  woman  is  gener- 
ally the  weakest  part  of  her  body,  while  the  normal  Jap- 
anese woman  satisfies  the  artist's  ideals  as  well  as  the 
surgeon's.  The  average  Japanese  woman  of  to-day  shows 
a  figure  as  perfectly  molded,  and  of  as  true  proportions, 
as  the  women  of  ancient  Greece  were  able  to  display. 

First  of  all,  the  Japanese  women  are  taught  that  life 
is  impossible  without  a  sufiicient  supply  of  fresh  air. 
This  internal  cleansing  with  air  is  deemed  of  more  impor- 
tance than  the  bath  which  follows  soon  after.  That  the 
Japanese  woman  is  a  deep  breather  is  shown  by  the  firm 
muscles  that  stand  out  on  the  abdomen. 

Consumption  is  a  rare  disease  in  Japan;  even  winter 
coughs  are  of  rare  occurrence.  The  Japanese  look  upon 
full,  deep  breathing  as  being  the  most  vital  function  in 
life;  food  is  not  so  important,  although  it  is  necessary. 
The  best  exercises  are  of  little  importance  when  the  breath- 
ing which  accompanies  them  is  not  properly  done. 

Improved  Physique  as  the  Result  of  Physical  Train- 
ing.— Dr.  Mary  Taylor  Bissell,  formerly  the  medical 
director  of  the  New  York  Berkeley  Ladies  Athletic  Glub, 


PHYSICAL  TRAINING  THE   KEY  TO   HEALTH         275 

and  one  of  the  pioneers  in  the  systematic  physical  training 
for  women,  gave  as  the  result  of  her  experience  there, 
"The  gain  of  twelve  months'  exercise  in  the  gymnasium 
is,  for  the  chest  two  inches,  stature  two  inches,  and  an  in- 
crease of  30  per  cent,  in  the  lung  capacity;  many  of  the 
strength  tests  were  doubled,  the  spine  became  erect  and 
the  arm  vigorous,  and  the  girl  gained  for  herself  the  con- 
sciousness of  controlling  her  own  body  instead  of  having 
it  control  her." 

Increasing  Stature  and  Improved  Physique  of 
American  Men. — Dr.  Born's  measurements  of  Yale 
athletes  and  students  suggest  the  inference  that  American 
men  are  becoming  physically  greater  than  any  other  known 
race.  Comparing  averages  in  1903  and  1908,  it  appears 
that  Yale  men  are  one  inch  and  a  half  taller  than  their 
predecessors  of  five  years  ago;  they  are  twenty-seven 
pounds  heavier,  broader  chested,  and  have  an  increased 
lung  capacity  of  seventy-two  cubic  inches. 

The  measurements  of  Harvard  students,  published  last 
fall  by  Dr.  Sargent,  corroborate  Dr.  Born's  deductions, 
that  American  college  men  have  larger  and  more  vigorous 
bodies  than  their  fathers. 

Dr.  Sargent's  association  of  vigorous  brains  with  strong 
bodies  is  borne  out  by  Professor  W.  T.  Porter's  examina- 
tion of  30,000  school-children  in  St.  Louis  in  1893,  and  by 
subsequent  observations  made  by  other  men. 

It  is  the  opinion  of  Dr.  Crampton,  director  of  physical 
training  in  the  New  York  city  schools,  that  this  improved 
physique  in  American  men,  observed  in  the  universities, 
is  not  in  a  small  measure  due  to  the  fact  that  within  the  last 
five  years  athletics  have  been  introduced  into  the  pubfic 
schools,  so  that  there  are  now  hundreds  of  teams  of  base- 
ball, football,  basket-ball,  and  track  athletics,  where  there 
was  only  one  before,  so  that  already  the  colleges  are  re- 
porting that  the  young  men  entering  them  are  bigger  than 
they  were  ten  years  ago. 

Professor  Phillips  of  Amherst  thinks  that  the  young 
women  are  certainly  one  inch  taller  and  five  pounds  heavier 


276  PERSONAL  HYGIENE  FOR  WOMEN 

than  they  were  ten  years  ago.  This  improved  physique 
of  Americans  he  attributes,  like  Dr.  Crampton,  to  the  fact 
that  the  American  boy  has  now  come  in  for  his  heritage  of 
athletic  sports,  and  he  makes  a  strong  plea  for  "adult 
play" — that  every  man  and  woman  should  have  as  good 
an  opportunity  as  boys  and  girls  to  get  out  on  an  open 
space  and  play  baseball,  football,  hockey,  run,  jump,  and 
have  a  good  time. 

To  show  the  importance  which  Great  Britain  places 
on  physical  training  for  boys  and  girls  the  following 
report  of  the  Royal  Commission  of  that  country  for  1903 
is  given  under  the  caption  "  A  National  System  of  Physical 
Training." 

Report  of  Royal  Commission  of  Great  Britain  on 
Physical  Training. — "  (1)  Physical  training  should  be 
regarded  as  of  equal  importance  with  mental  training. 

"  (2)  During  school  life  physical  training  is  quite  as 
important  for  girls  as  for  boys. 

"  (3)  Systematic  physical  training  is  necessary  both  for 
country  and  town  children. 

''The  daily  walk  to  school  is  exercise,  but  not  exercise 
which  develops  the  body  as  a  whole,  or  counteracts 
the  hability  to  stoop,  to  be  round-shouldered,  or  to  be 
slovenly  in  gait.  Moreover,  all  children  during  school 
life  must  spend  many  hours  with  but  little  change  of 
position,  the  effects  of  which  can  only  be  corrected  by 
systematic  physical  exercise. 

"  It  should  aim  at  the  healthy  development  of  the  body, 
as  well  as  of  the  mind,  by  the  regular  development  of  all 
the  muscles,  the  quickening  of  the  intelligence  and 
activity,  and  the  formation  of  the  habits  of  prompt 
obedience,  precision,  smartness,  and  discipline.  The 
exercises  should  not  be  for  mere  display  or  entertain- 
ment, but  each  should  have  its  particular  purpose  and 
value  to  develop  all  parts  of  the  body. 

''A  certain  amount  of  physical  exercise  once  a  day  or 
oftener  is  preferable  to  even  a  greater  amount,  at  longer 
or  irregular  intervals. 


PHYSICAL  TRAINING  THE   KEY  TO  HEALTH         277 

"Games  are  very  useful  and  ought  to  be  encouraged, 
but  they  cannot  be  played  by  all  children,  and  usually 
the  weaker  ones  go  to  the  wall ;  that  is,  those  most  needing 
systematic  development  are  excluded.  Games  affording 
opportunities  for  violent  exercise  are  useful  for  the 
development  of  reserve  strength,  and  form  an  admirable 
field  for  the  cultivation  of  social  and  public  spirit.  We 
strongly  favor  their  organization  and  development  at  all 
schools, 

"For  boys,  in  addition  to  the  regular  games,  country 
runs,  leaping  and  dancing  the  Highland  Fling;  for  girls, 
skipping  and  hockey.  For  both,  swimming  is  strongly 
advised." 

Physical  Training  Among  the  Ancients. — Greek 
culture  regarded  the  individual  as  valuable  in  and  for 
himself,  and  sought  to  promote  first  of  all  his  full  and 
free  development.  The  idea  was  symmetry  and  balance 
of  parts,  and,  to  attain  complete  and  harmonious  man- 
hood, mind  and  body  were  trained  together. 

Games  played  an  important  part  in  the  life  of  the 
Athenians,  and  their  importance  in  the  education  of 
children  was  early  recogTiized. 

From  the  age  of  seven  to  sixteen  it  is  probable  that 
one-half  of  the  day  of  the  Athenian  boy  was  spent  in 
intellectual  and  the  other  half  in  physical  education. 
The  aim  of  the  Athenian  education  was  to  produce  men, 
independent  but  respectful,  freedom  loving  but  law 
abiding,  healthy  in  mind  and  body,  clear  in  thought, 
ready  in  action,  and  devoted  to  their  families,  their 
fatherland,  and  their  gods. 

Gymnastics  included  everything  reb,ting  to  the  culture 
of  the  body. 

The  culmination  of  the  Athenian  education  was  danc- 
ing. As  a  supplement  to  gymnastic  culture,  it  toned 
down  the  ardent  exercise  of  the  gymnasium  and  the  over- 
energy  of  muscular  development  to  the  ease  and  grace 
which  was  the  Athenian  ideal. 

The  Romans. — The  early  Romans  possessed  some  traits 


278  PERSONAL   HYGIENE   FOR  WOMEN 

in  common  with  the  Spartans.  They  were  intensely  prac- 
tical and  interested  in  those  things  whose  usefulness  was 
apparent.  Education  should  fit  a  man  for  his  work  in 
the  world. 

A  Roman  structure,  quite  as  characteristic  as  the  Greek 
gymnasium,  was  the  public  bath  or  therma,  found  not 
only  in  Rome,  but  in  every  important  provincial  town 
in  the  days  of  the  empire.  Both  made  provision  for 
exercise  and  contained  a  system  of  baths,  but  in  the 
thermae  the  baths  occupied  the  greater  part  of  the  space, 
and  the  rooms  and  courts  for  exercise  were  smaller  and 
fewer. 

The  Influence  of  Physical  Training  on  the  Health 
and  Life  of  the  Individual. — If  we  believe,  with  Spencer, 
that  "Education  is  preparation  for  complete  living," 
we  must  appreciate  that  good  carriage,  bodily  control, 
physical  judgment,  will  power,  and  courage  are  an  im- 
portant part  of  the  equipment  of  every  man  and  woman. 
These  qualities  are  intimately  associated  with  motor 
coordination,  and  they  are  best  developed  through 
physical  training. 

The  power  of  self-preservation,  by  which  the  individual 
is  enabled  to  handle  his  body  easily  under  all  conditions, 
and  so  escape  physical  injury  and  death,  depends  upon 
physical  judgment  of  time  and  distance,  and  the  ability 
to  run,  jump,  vault,  climb,  and  swim.  These  are  all 
fundamental  exercises. 

The  love  of  play  and  the  ability  to  play  a  number  of 
games  contribute  very  largely  to  health  and  happiness. 
The  play  habit  must  be  acquired  in  youth  or  it  will  never 
be  developed. 

The  best  qualities  of  mind  and  character  can  only  be 
obtained  through  physical  experience  and  physical 
struggle.  With  stalwart  physique  comes  a  vigorous 
type  of  womanhood,  physical  courage ;  with  flabby  muscles 
there  is  apt  to  result  flabby  thinking  and  flabby  acting, 
superficiality,  and  inefiiciency.  Next  to  hunger  the  most 
dominant  instinct  is  the  play  instinct. 


PHYSICAL  TRAINING  THE  KEY  TO  HEALTH         279 

The  Effect  of  Exercise  on  Brain  Development  and 
Character. — The  growing  interest  in  preventive  medicine, 
and  the  very  great  popularity  of  the  opportunities  afforded 
for  athletic  training,  attest  to  the  value  which  people 
are  beginning  to  place  upon  health  as  an  asset  in  their 
social,  domestic,  business,  and  professional  lives. 

But  it  is  not  generally  or  sufficiently  understood  just 
how  great  is  the  effect  of  physical  training  on  the  develop- 
ment of  the  brain  or  upon  the  mental  activities.  With 
a  strong,  vigorous  action  of  the  heart  there  is  a  feeling  of 
courage  and  general  exaltation,  whereas  with  a  weak 
heart  and  enfeebled  circulation,  fear  and  impaired  mental 
activity  predominate. 

The  manner  in  which  the  organic  functions  are  per- 
formed not  only  determine  the  health  of  the  body,  but  the 
temperament  and  character  as  well.  There  is  a  conserva- 
tion of  energy  in  the  fashioning  of  the  will — only  part 
of  the  energy  is  expended  in  the  outward  effort,  while 
the  rest  goes  to  lay  the  foundation  of  a  future  will,  so  that 
exercise  builds  up  faculty  and  conduct  character. 

We  cannot  perform  an  act  voluntarily  unless  we  know 
what  we  are  going  to  do,  and  we  cannot  know  exactly 
what  we  are  going  to  do  until  we  have  learned  to  do  it. 
The  very  simplest  movement  brings  about  a  change 
in  the  organic  structure  of  the  brain,  and  this  change 
leads  to  more  complex  movements  and  further  improve- 
ment in  brain  structure.  Most  skilled  movements  give 
more  exercise  to  the  central  nervous  system  than  to  the 
muscles.  Movements  calling  for  a  high  degree  of  skill, 
correlation  of  the  different  senses,  sense  discrimination, 
fine  coordinations,  and  a  rapid  and  responsible  exercise 
of  judgment,  all  tend,  through  the  action  of  the  association 
fibers,  to  a  high  degree  of  brain  development. 

An  essential  feature  of  exercise  is  that  a  part  of  it  at 
least  shall  afford  amusement,  diversion,  and  recreation 
to  the  overwearied  and  harassed  brain.  Hence,  the 
necessity  to  introduce  dancing,  field  sports,  etc.  By 
these   means   industrial   efficiency,   communal   morality, 


280  PERSONAL  HYGIENE   FOR  WOMEN 

and  social  consciousness  are  promoted.  Public  amuse- 
ments of  a  proper  sort  are  a  public  necessity. 

The  great  menace  to  the  city  is  the  limited  opportunities 
for  healthful  play,  and  over  one-third  of  the  population 
of  the  United  States  live  in  towns.  The  physical  side  of 
the  question  is  the  largest,  for  it  involves  health,  and 
consequently  poise  and  self-control.  It  involves  a  legiti- 
mate occupation  of  surplus  energy  and  its  wise  direction, 
and  it  also  involves  companionship. 

The  great  object  of  physical  training  is  then  to  secure 
the  most  perfect  development  of  the  body,  with  the 
corresponding  development  of  the  brain,  so  that  the 
highest  physical  and  mental  efficiency  of  the  individual 
may  be  attained. 

The  possession  of  a  large  reserve  of  muscle  and  nerve 
force,  ready  to  be  used  in  any  emergency,  gives  confidence 
to  the  individual,  increases  the  spirit  of  taking  the  initia- 
tive and  undertaking  grave  responsibilities  that  come 
into  the  life  of  everj^  woman,  especially  those  who  are 
engaged  in  the  business  or  professional  world,  and  the 
building  up  of  this  necessary  reserve  force  is  one  of  the 
inestimable  advantages  of  a  gymnastic  and  athletic 
training. 

The  Physiology  and  Pathology  of  Exercise.  — Exer- 
cise is  divided  into  active  or  voluntary  and  passive. 

Passive  exercise  does  not  require  any  exertion  of  the 
will  power.  Massage  increases  the  local  nutrition  of  the 
parts,  stimulates  the  nerves,  and  is  restful,  rather  than 
exhausting,  to  the  overwrought  brain  and  wearied  nerves. 
'  Active  exercise  is  further  divided  into  exercise  of 
effort  and  exercise  of  endurance.  Under  exercise  of 
effort  are  classed  all  gymnastic  feats.  The  primary  object 
of  a  gymnastic  training  or  education  is  to  produce  a 
symmetric  development  of  the  entire  body,  while,  on 
the  other  hand,  the  training  necessary  to  execute  gym- 
nastic feats  produces  an  overdevelopment  of  one  part 
of  the  body  at  the  expense  of  the  rest,  as  is  seen  in  the  arm 
of  the  blacksmith  and   the  leg  of  the  danseuse.     All 


PHYSICAL  TRAINING  THE   KEY  TO  HEALTH         281 

exercises  of  effort,  whether  of  strength,  skill,  or  speed, 
demand  and  cultivate  mental  concentration,  a  rapid 
response  of  the  muscle  to  the  orders  of  the  will,  develop 
the  power  to  accomplish  complicated  coordinations, 
and  the  knowledge  of  how  these  difficult  movements 
may  be  performed  with  the  least  expenditure  of  nerve  and 
muscle  force.  Exercising  a  muscle  develops  it  up  to  its 
physiologic  capacity,  but  if  a  muscle  is  habitually  over- 
worked, pathologic  results  occur,  and  instead  of  a  quick, 
sharp  contraction  of  the  muscle,  the  contractions  will  be 
weak  and  uncertain,  and,  if  carried  too  far,  the  muscle 
may  eventually  atrophy  from  overwork. 

Exercises  of  endurance  include  walking,  running,  swim- 
ming, and  rowing — the  range  of^movement  in  these  is  much 
more  hmited  than  in  exercises  of  effort.  In  these,  each 
movement  is  well  within  the  individual's  powers,  yet,  by 
increasing  the  rapidity  of  the  movements,  or  by  their 
prolonged  continuance,  the  total  amount  of  muscular 
work  accomplished  may  be  very  great.  Normally,  the 
contraction  and  relaxation  of  the  muscles  are  compara- 
tively slow,  so  that  the  poisonous  waste  matter  produc- 
ing fatigue  is  continually  being  removed  from  the  tissues, 
and  not  allowed  to  accumulate;  whereas,  in  exercises 
of  effort,  there  is  no  time  allowed  for  the  scavengers 
to  work,  and  fatigue  of  the  most  active  muscles  sets  in 
rapidly. 

Fatigue  may  appear  in  several  forms,  depending  on  the 
character  of  the  exercise  which  produced  it.  When  the 
exercise  is  sufficiently  active,  the  amount  of  waste  matter 
thrown  into  the  circulation  is  greater  than  can  be  ehmin- 
ated  by  the  lungs;  breathlessness  and  palpitation  of  the 
heart  result;  so  soon  as  the  equilibrium  between  waste 
production  and  elimination  is  estabhshed,  the  individual 
is  said  to  have  gotten  his  second  wind.  Or,  again,  a  slow 
pace,  too  long  kept  up,  will  produce  exhaustion,  so  that  the 
products  of  tissue  waste  accumulate,  the  beat  of  the  heart 
is  fast,  irregular  and  weak,  the  nervous  system  becomes 
stupefied,  and  the  muscles  fail  to  respond  to  the  normal 


282  PERSONAL  HYGIENE  FOR  WOMEN 

physiologic  stimulus.  This  is  a  form  of  fatigue  not  in- 
frequently found  among  zealous  housewives,  in  which  the 
demands  made  upon  the  nervous  system  by  continual  and 
carking  family  cares,  added  to  the  very  strenuous  work  of 
the  household,  exhausts  both  nervous  and  muscular  sys- 
tems. 

Recovery  from  this  form  of  fatigue  takes  a  much  longer 
time  than  the  preceding.  The  individual  is  too  tired  to 
sleep,  the  night  is  troubled  by  disturbed  dreams,  there  is 
a  soreness  and  stiffness  of  the  muscles  and  joints  which 
remain  for  some  days.  There  may  be  an  actual  rise  in 
temperature,  and  the  urine  passed  has  a  high  specific 
gravity,  with  sometimes  even  albumin. 

If,  now,  this  overwork  is  continued  over  prolonged  per- 
iods of  time,  without  allowing  suSicient  time  for  the  neces- 
sary recuperation,  there  follows  a  slow  and  profound  ex- 
haustion, which  is  much  more  difficult  to  overcome.  In 
this  condition  the  temperature  becomes  subnormal,  the 
weight  decreases,  the  skin  and  muscles  become  fiabby,  and 
the  skin  is  pale,  the  eyes  are  duU  and  listless,  and  the  indi- 
vidual is  without  ambition  to  rouse  herself  from  her 
lethargy. 

During  a  contraction  each  muscle-cell  shortens  and 
thickens,  giving  off  some  of  its  substance  into  the  lymph- 
space  which  surrounds  it,  and  absorbing  food,  consisting  of 
carbohydrates  and  oxygen,  from  the  surrounding  plasma. 
Exercise  improves  nutrition  by  the  rhythmic,  automatic 
massage  caused  by  the  contraction  and  relaxation  of  the 
muscles  on  the  vessels  which  they  contain,  while  warmth 
favors  the  efimination  of  waste  matter. 

It  has  been  proved  by  Hawk,  of  the  University  of  Penn- 
sylvania, in  his  experiments  on  the  blood-count  of  an 
athlete  in  training,  that  various  forms  of  active  muscular 
exercise  produce  an  average  increase  of  16.8  per  cent, 
in  the  number  of  red  corpuscles.  T\Tien  exercise  is  long- 
continued,  the  rate  of  increase  lessens,  and,  further,  the 
number  may  be  decreased  in  greatly  prolonged  violent 
exercise.     The  explanation  of  this  is  that  a  large  number 


PLATE   III 


Senegalese  woman.     (From  Stratz,  after  Dr.  Eykens,  in  Shufeldt's 
"Studies  of  the  Human  Form.") 


PHYSICAL  TRAINING  THE   KEY  TO  HEALTH         283 

of  cells  lie  inactive  in  various  tissues  of  the  body  until 
they  are  brought  into  the  circulation  by  muscular  exer- 
cise. 

Athletic  training  has  been  called  "mainly  heart  train- 
ing," Exercises  of  endurance  do  not  require  supreme 
efforts,  but  they  do  accelerate  the  action  of  the  heart  and 
lungs,  and  the  aggregate  of  work  done  is  very  much  greater 
than  in  exercises  of  strength,  but  the  exercise  must  be 
sufficiently  active  to  provide  for  the  free  circulation  of 
lymph,  which  is  carried  on  mainly  through  the  massage  of 
muscular  contraction. 

If  a  walk  be  so  Hstless  that  there  is  not  sufficient  move- 
ment of  the  muscles  to  overcome  the  pernicious  influence 
of  gravity  acting  on  the  colunm  of  blood  contained  in  the 
veins  of  the  abdomen,  thighs,  and  legs,  the  vessel-walls 
may  become  permanently  overstretched  and  varicose. 
The  exercise  must  be  sufficiently  active  for  the  muscular 
contractions  to  empty  the  lymph-spaces  and  hasten  the 
circulation.  It  usually  raises  the  general  bodily,  as  well 
as  the  local,  temperature  of  the  parts,  and  so  facilitates  the 
removal  of  the  waste-products. 

The  acquirement  of  skill  lies  in  the  training  of  the  nerve 
rather  than  the  muscle.  A  simple  movement  requires 
only  a  nerve  impulse  to  the  acting  muscle,  while  a  com- 
plicated movement  requires  a  wave  of  impulses  to  the 
accessory  and  antagonistic  groups  of  muscles  which  control 
and  steady  the  movement.  It  is  easy  to  see  how,  in  the 
first  efforts  to  perform  comphcated  movements,  the  con- 
tractions of  the  muscles  wiU  be  jerky  and  inaccurate, 
many  useless  muscles  wiU  be  employed,  and  the  expendi- 
ture of  nervous  energy  will  be  out  of  all  proportion  to  the 
result,  and  these  first  attempts  at  new  feats  of  skiU  rapidly 
exhaust  the  attention.  This  is  well  illustrated  in  the  first 
efforts  of  a  child  learning  to  walk. 

Exercises  of  strength  and  skill  train  that  alertness  of 
mind  so  essential  in  ordinary  life.  They  shorten  the  period 
between  thought  and  action,  producing  what  is  known  as 
"presence  of  mind." 


284  PERSONAL  HYGIENE  FOR  WOMEN 

The  Relative  Proportions  of  a  Perfect  Female 
Form. — The  relative  proportions  of  a  perfect  female  form, 
as  deduced  by  modern  sculptors  from  the  Greek  statues, 
are  as  follows:  With  a  height  of  five  feet  five  inches,  the 
weight  should  be  one  hundred  and  thirty-eight  pounds. 
The  woman  should,  with  the  arms  extended,  measure 
from  tip  to  tip  of  the  middle  finger,  five  feet  five  inches; 
that  is,  exactly  her  own  height.  The  length  of  the  hand 
should  be  one-tenth,  the  foot  one-seventh,  and  the  di- 
ameter of  the  chest  one-fifth  that  of  the  height.  The 
distance  from  the  perineum  to  the  ground  should  meas- 
ure the  same  as  from  the  perineum  to  the  top  of  the 
head.  The  knee  should  be  exactly  midway  between  the 
perineum  and  the  heel.  The  distance  from  the  elbow 
to  the  httle  finger  should  be  the  same  as  the  distance  from 
the  elbow  to  the  middle  of  the  chest.  The  measurement 
from  the  top  of  the  head  to  the  chin  should  be  the  same  as 
the  length  of  the  foot,  and  there  should  be  the  same  dis- 
tance between  the  chin  and  the  armpits.  A  woman  of  this 
height  should  measure  twenty-nine  inches  around  the  waist, 
thirty-four  inches  around  the  bust,  if  taken  under  the  arms, 
and  forty-three  inches  if  measured  over  them.  The  upper 
arm  should  measure  thirteen  inches  and  the  wrist  six  inches. 
The  calf  of  the  leg  should  measure  fourteen  and  one-haK 
inches,  the  thigh  twenty-five  inches,  and  the  ankle  eight 
inches. 

The  table  on  page  285,  compiled  by  Dr.  Weisse,  the  Med- 
ical Statistician  of  the  New  York  Life  Insurance  Company, 
"A  Table  of  Standard  Weights  for  Women,"  is  based  on 
the  average  weights  of  over  58,000  insured  women,  and  is 
given  to  show  the  normal  relation  between  the  height  and 
weight.  A  point  of  extreme  interest  in  the  table,  and  one 
that  is  not  generally  recognized,  is  the  variation  in  weight, 
independent  of  the  height,  at  different  ages. 


PLATE  IV 


Juno. 


PLATE   V 


Venus  de  Capua. 


PHYSICAL  TRAINING  THE  KEY  TO  HEALTH 


285 


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286  PERSONAL  HYGIENE   FOR  WOMEN 

Dr.  Weisse  found  the  average  height  of  women  to  be  five 
feet  four  inches,  and  the  average  weight  one  hundred  and 
thirty-three  pounds,  and  that  the  average  male  height  was 
three  inches  greater  than  that  of  the  female. 

Women  should  range  in  weight  from  one  and  eight-tenths 
to  two  and  two-thirds  pounds  to  each  inch  in  height.  In 
order  to  determine  your  own  factor  in  this  respect  divide 
your  weight  in  pounds  by  your  height  in  inches.  Any 
weight  above  two  and  one-half  pounds  to  the  inch  in 
stature  may  be  considered  as  excessive,  inasmuch  as  it  adds 
nothing  to  one's  mental  or  physical  efhciency,  and  is  fre- 
quently the  forerunner  of  obesity,  the  remedy  for  which 
is  to  live  on  a  selected  diet  and  to  burn  up  more  through 
exercise. 

In  an  ideal  condition  there  is  a  sufficient  quantity  of 
fat  to  give  a  pleasing  rotundity  of  outUne.  In  women 
the  tendency  is  for  fat  to  accumulate,  especially  after 
forty  years  of  age,  about  the  waist,  abdomen,  and  upper 
part  of  the  thighs.  In  addition  to  the  unsightliness 
which  this  gives  to  the  figure,  it  is  often  the  indication 
of  the  fatty  degeneration  of  the  muscles,  and  the  heart 
is  liable  to  become  involved,  and  fatty  degeneration  of 
the  heart  is  one  of  the  frequent  causes  of  death.  The 
lack  of  use  of  the  muscles  in  these  regions  of  the  body, 
which  is  caused  by  wearing  corsets,  is  the  reason  for  the 
accumulation  of  fat  here.  It  can  be  reduced  by  the 
proper  exercises  and  regulated  diet. 

The  Muscular  System. — The  bony  skeleton  forms 
simply  the  framework  of  the  body,  and,  while  it  determines 
the  general  outlines  and  height  for  the  most  part,  the 
weight  and  general  size  of  the  body  depend  upon  the 
muscular  development  and  the  amount  of  adipose  tissue. 
The  bones  are  not  only  padded  about  with  muscles,  but 
the  muscles  are  inserted  into  the  bony  sheaths  in  such  a 
way  that  a  development  of  the  muscles  causes  a  develop- 
ment of  the  bones  as  well.  Again,  the  stature  is  increased 
by  the  erect  position  of  the  spinal  column,  and  this  can 
only  be  attained  by  great  strength  of  the  muscles  which 


PLATE   VI 


Venus  de  Medici. 


PLATE  VII 


Venus  de  Milo. 


PHYSICAL  TRAINING  THE   KEY  TO  HEALTH 


287 


hold  the  spine  erect.  The  inequalities  of  the  muscles  are 
filled  out  with  adipose  tissue,  giving  a  pleasing  contour 
to  the  face  and  figure. 

There  are  some  five  hundred  muscles  in  the  human 
body;  these  muscles  vary  in  size  and  form,  according  to 


Fig.  21.— The  skeleton  (Lewis). 

their  situations  in  the  body  and  the  functions  which  they 
are  called  on  to  perform. 

Nearly  all  the  muscles  in  the  body  are  arranged  in 
two  different  or  antagonistic  sets,  and  are  placed  on  the 
opposite  sides  of  the  part,  so  that  in  acting — that  is,  by 


288 


PERSONAL  HYGIENE   FOR  WOMEN 


their  contractions  or  shortening — they  move  the  Hmb 
in  opposite  directions,  and  it  is  by  the  alternate  contrac- 
tion, or  shortening  and  relaxation  of  the  two  sets  of 
muscles,  that  the  movements  of  the  body  are  accomplished. 
The  muscles  which  bend  the  joints  are  called  flexors, 
while  those  that  extend  the  joints  are  called  extensors, 
so  that  in  order  to  perform  their  work,  which  is  that  of 
contraction,  the  muscles  must  exert  enough  force  to 
elongate  the  opposing  muscles,  overcome  the  tonicity 
of  the  antagonizing  muscles,  and  lift  the  weight  of  that 
portion  of  the  limb  into  which  they  are  inserted.    It  is 


Fig. 


22. — ^Muscular  fibers, 
highly  magnified. 


Fig.  23. — Different  directions  of 
fibers  in  the  three  layers  of  abdom- 
inal muscles. 


by   the   action  of  the  muscles  that  the   body  is  held 
upright. 

Action  of  the  Muscles  of  the  Abdomen. — The  trunk  is 
maintained  from  falling  backward  by  the  action  of  those 
huge  muscles  on  its  anterior  surface.  The  space  between 
the  pelvis  and  the  thorax  is  called  the  abdominal  cavity. 
Its  walls  are  almost  wholly  composed  of  muscles.  There 
are  several  important  facts  to  be  noted  about  these 
muscles.  First,  that  they  extend  from  the  brim  of  the 
pelvis,  into  which  they  are  inserted,  to  the  ribs  and  breast 
bone,  to  which  the  other  ends  of  these  muscles  are  attached; 


PHYSICAL  TRAINING  THE   KEY  TO   HEALTH 


289 


that  there  are  three  layers  of  these  muscles;  and,  lastly, 
that  the  fibers  of  the  different  layers  run  in  different 
directions,  so  that  they  cross  each  other,  as  shown  in  the 
figure.  The  reenforcement  of  the  layers,  the  arrange- 
ment of  their  fibers,  and  the  manner  in  which  they  dove- 


Fig.  24. — Muscles  of  the  anterior  surface  of  the  tnuik  (left  side, 
superficial;  right  side,  deep). 

tail  into  the  adjacent  groups  of  fibers  give  a  structure  of 
the  greatest  possible  strength. 

Action  of  the  Muscles  of  the  Back. — The  tmnk  is  kept 
from  falling  forward  by  the  action  of  the  muscles  of  the 
back.  These  are  arranged  in  six  layers.  The  cut  shows 
the  direction  of  the  fibers.  The  first,  or  outside  layer, 
consists  of  the  trapezius  and  latissimus  dorsi,  or,  in  other 

19 


290 


PERSONAL  HYGIENE  FOR  WOMEN 


words,  the  broad  muscle  of  the  back.  On  the  one  side 
these  muscles  are  attached  to  the  spines  of  the  vertebrae; 
the  sharp  ridge  which  is  felt  in  the  middle  of  the  back, 
and  the  broad  attachment  to  the  pelvis  afford  a  firm  base 
of  support.     There  are  other  muscles  which  run  parallel 


Fig.  25. — ^Muscles  of  the  posterior  surface  of  the  trunk  (left  side, 
superficial;  right  side,  deep). 

with  the  spinal  column,  whose  function  it  is  to  hold  the 
spinal  column  erect. 

Standing  erect  calls  into  action  almost  all  the  muscles 
of  the  lower  extremities,  trunk,  and  neck.  So  long  as 
the  line  of  gravity  falls  within  the  line  of  the  feet,  the 
muscular  effort  required  is  so  slight  that  it  is  little  more 
than  the  tonicity  contained  in  all  living  muscle.    The 


PHYSICAL  TRAINING  THE   KEY  TO  HEALTH         291 

greater  the  displacement  of  the  line  of  gravity,  the  greater 
the  muscular  effort  required  to  maintain  the  equilibrium 
of  the  body. 

Muscular  Energy. — The  muscles  of  the  body,  even  when 
at  rest,  are  under  a  slight  degree  of  tension.  When  stimu- 
lated, the  muscle  contracts — that  is,  it  becomes  shorter 
and  thicker.  A  muscle  can  only  remain  in  a  state  of 
contraction  for  a  few  seconds,  because  the  force  of  the 
muscular  fibers  is  more  or  less  exhausted  during  contrac- 
tion. The  more  rapid  the  contractions,  the  sooner  does 
fatigue  manifest  itself. 

Like  the  steam  engine,  the  muscles  of  the  body,  in 
performing  their  work,  produce  heat  and  motion.  The 
fuel  which  supplies  this  force  is  taken  into  the  body  in 
the  shape  of  food;  it  is  prepared  for  use  in  the  intestinal 
tract,  and  from  there  carried  by  the  blood,  to  be  stored 
up  in  the  muscles  and  various  tissues  as  latent  force. 
The  muscles  contain  one-fourth  of  all  the  blood  in  the 
body. 

Heat  Production. — By  watching  a  muscle  when  con- 
tracting, we  see  that  there  is  not  only  a  change  of  shape, 
but  a  dilatation  of  its  blood-vessels,  that  is,  more  blood 
passes  through  a  muscle  when  it  is  contracting  than 
when  it  is  at  rest,  and  this  increased  flow  continues  for 
some  little  time  after  the  contraction  has  ceased;  there 
is  also  a  rise  of  temperature.  Nearly  three-fourths  of  the 
heat  developed  in  the  body  is  produced  in  the  muscles 
at  the  actual  moment  of  muscular  contraction.  Hence, 
we  learn  that  the  whole  body  is  heated  by  muscular 
exercise;  the  even  temperature  of  the  various  parts  is 
maintained  through  the  circulation  of  the  blood.  This 
combustion,  going  on  throughout  the  entire  economy, 
is  the  source  of  all  force  or  energy  in  the  body.  In  every 
movement,  every  breath  taken,  in  the  change  even  of  a 
muscle  of  expression  or  the  conception  of  a  passing  fancy, 
combustion  has  occurred  and  potential  force  has  been 
liberated. 

Muscular  Fatigue. — The  fatigue  produced  by  muscular 


292  PERSONAL  HYGIENE  FOR  WOMEN 

contraction  may  be  due  to  the  consumption  of  the  readily 
available  material  present  in  the  muscle,  to  the  consump- 
tion of  the  supply  of  oxygen,  or  to  the  presence  of  the 
products  of  combustion,  and,  if  Weichardt's  theory  is 
correct,  to  these  must  be  added  the  presence  of  a  definite 
"fatigue  toxin." 

During  repose  the  internal  changes  of  the  tissue  manu- 
facture new  explosive  material  out  of  the  comparatively 
raw  material  already  present  in  the  fiber,  and  the  directly 
hurtful  products  of  the  act  of  combustion  are  either  carried 
off,  or  undergo  changes  by  which  they  are  converted  into 
comparatively  inert  bodies.  A  stream  of  fresh  blood 
may  exert  its  restorative  influence,  not  only  by  quickening 
both  of  these  events,  but  also  by  carrying  off  the  immediate 
waste-products,  while,  at  the  same  time,  it  brings  new  raw 
material. 

Every  movement  of  the  body  depends  as  much  upon 
the  proper  coordination  of  the  muscles  for  its  accuracy, 
grace,  and  force  as  upon  the  strength  of  their  contraction, 
and  while  the  fatigue,  of  which  we  are  conscious  in  our  own 
bodies  after  prolonged  or  unusual  exertion,  arises  partly 
from  the  exhaustion  of  the  motor  nerves,  it  is  chiefly 
from  the  exhaustion  of  the  central  nervous  system  con- 
cerned in  the  production  of  voluntary  impulses.  A  man 
who  feels  absolutely  exhausted  may,  under  excitement, 
perform  a  very  large  amount  of  work  with  his  already 
wearied  muscles.  The  will  rarely,  if  ever,  calls  forth 
the  greatest  amount  of  contraction  of  which  the  muscle 
is  capable. 

Passive  Exercise :  Massage. — Massage  has  been  de- 
fined as  the  systematic  manipulation  of  the  surface  of  the 
body  by  the  hands  of  the  operator  in  movements  of  strok- 
ing, pinching,  kneading,  and  striking.  The  passive  move- 
ments consist  of  flexions,  extensions,  rotations,  and  other 
movements  of  joints  and  limbs  by  an  operator  or  machine 
without  the  cooperation  or  resistance  of  the  patient. 

Massage  takes  the  place  of  voluntaiy  muscular  move- 
ment, in  promoting  the  flow  of  lymph  and  the  flow  of 


PHYSICAL  TRAINING  THE   KEY  TO   HEALTH         293 

venous  blood  toward  the  heart,  if  the  proper  direction, 
that  of  rubbing  toward  the  heart,  be  followed;  while, 
on  the  contrary,  rubbing  down  a  limb  or  from  the  heart 
actually  retards  the  process  which  it  is  meant  to  facilitate. 
Gentle  rubbing  of  any  part  of  the  body  promotes  growth, 
while  vigorous  rubbing  removes  superfluous  fat. 

Massage  finds  its  widest  field  of  usefulness  in  conditions 
of  fatigue,  where  the  elimination  of  waste  matter  must  be 
assisted,  and  where  the  nutrition  of  a  part  is  impaired  or 
destroyed.  Muscles  can  be  improved  in  size,  tone,  and 
nutrition;  ligaments  can  be  stretched  and  lengthened, 
the  general  circulation  accelerated,  and  overloaded  veins 
made  to  disgorge  their  blood.  The  digestive  tract  can  be 
stimulated,  and  overwrought  nerves  soothed  and  relieved 
of  their  hypersensibility. 

The  nourishment  of  the  muscle-cell  is  improved  by  forc- 
ing out  the  products  of  fatigue  and  keeping  it  bathed  in  a 
constantly  renewed  stream  of  arterial  blood.  This  alone 
is  sufficient  to  prevent  wasting  of  substance  in  conditions 
where  active  movements  are  impossible. 

Massage  relieves  the  nervous  system  by  maintaining  the 
nutrition  of  the  muscles,  without  the  expenditure  of  nerve 
force  required  to  make  them  contract.  It  acts  on  the 
central  nervous  system  through  the  nerves  of  sense,  stimu- 
lating or  soothing  them,  according  to  the  nature  and  the 
amount  of  the  manipulation. 

Mosso  and  Maggiora,  of  Turin,  have  proved,  by  their 
experiments  as  to  the  effect  of  massage  on  the  muscles, 
that  muscles  were  capable  of  doing  twice  as  much  work 
after  massage.  It  was  also  discovered  that  extending  of  the 
period  of  the  massage  did  not  produce  any  greater  results 
in  the  capacity  for  work;  the  full  effect  was  obtained  in 
five  minutes. 

The  action  of  massage  in  improving  muscle  tone,  in 
postponing  the  onset  of  fatigue,  and  hastening  recovery 
from  it  has  long  been  recognized  by  athletic  trainers. 
After  a  hard  race  or  other  contest,  it  is  a  matter  of  knowl- 
edge among  trainers  that  a  five  minutes'  treatment  will 


294  PERSONAL  HYGIENE   FOR  WOMEN 

enable  an  athlete  to  repeat  or  continue  a  performance 
otherwise  impossible. 

Massage  is  the  most  economic  form  of  exercise  on  the 
nervous  system.  Its  potency  is  shown  by  the  increase  of 
the  red-blood  corpuscles  and  hemoglobin,  and  by  the  in- 
creased rate  and  force  of  the  heart's  beat  without  a  corres- 
ponding change  in  the  arterial  tension.  It  accomplishes 
these  results  by  decreasing  the  resistance  in  the  peripheral 
vessels,  by  the  removal  of  the  products  of  oxidation,  and 
by  mechanically  moving  the  blood-current  forward  in  the 
lymph-spaces  and  venous  channels.  It  is  thus  shown  to 
stimulate  the  circulation,  the  respiration,  nutrition,  and 
excretion. 

Mezger  describes  four  principal  manipulations:  First, 
stroking  or  effleurage,  in  which  the  hand  is  passed  lightly 
over  the  skin,  with  the  pressure  from  the  periphery  to  the 
center,  following  the  course  of  the  venous  circulation,  and 
the  long  direction  of  the  muscles  from  their  insertion  to 
their  origin.  It  may  be  performed  by  stroking  with  the 
palm  of  one  or  both  hands,  with  the  thumb  or  tips  of  the 
fingers.  The  two  hands  are  used  upon  the  large  fleshy 
parts  of  the  thighs  and  buttocks,  the  back,  chest,  and 
neck. 

Second,  Friction. — This  is  a  deep  circular  movement,  per- 
formed with  the  thumbs  and  tips  of  the  fingers,  or  by  one 
hand  open  or  clenched.  The  products  of  fatigue  collect- 
ing in  deep  muscular  tissues  are  thus  thrown  into  the  cir- 
culation, the  gentle  manipulations  of  stroking  carrying 
them  into  the  superficial  veins.  The  friction  should  pro- 
ceed in  the  same  direction  as  the  stroking  movements. 

Third,  petrissage,  also  described  as  pinching  and 
grasping,  is  performed  by  picking  up  the  skin  and  subcu- 
taneous tissues  between  the  thumb  and  fingers,  and  manip- 
ulating it  with  an  amount  of  force  not  sufficient  to  cause 
pain.  In  this  procedure  the  skin  moves  with  the  hand  of 
the  operator,  and  the  underlying  structures  are  thus 
massaged  by  it  under  the  pressure  of  the  fingers.  The 
thumb  and  fingers  are  used  to  reach  the  individual  muscles 


PHYSICAL  TRAINING  THE   KEY  TO   HEALTH         295 

and  small  groups.  The  movements  should  proceed  from 
the  periphery  toward  the  center.  It  is  used  to  improve 
muscular  nutrition  in  case  of  fatigue,  in  atrophy,  in  obesity, 
and  other  forms  of  muscular  degeneration. 

Fourth,  Striking,  Tapotement,  or  Percussion. — Other 
names  are  clapping,  beating,  knocking,  or  hacking.  It 
has  a  stimulating  action  on  the  skin,  superficial  nerves, 
and  vessels.  Hacking  is  performed  by  the  ulnar  border 
of  the  hand,  and  is  used  along  the  nerve-trunks. 

Fifth,  Shaking  or  Vibration. — Shaking  involves  move- 
ments of  the  whole  body  or  region  to  be  treated,  while 
vibration  is  a  lesser  motion  in  which  the  body  or  region 
remains  at  rest,  while  the  surface  and  the  structures  im- 
mediately beneath  it  are  affected. 

General  massage  is  best  given  at  an  hour  midway  between 
meals,  and  never  immediately  after  eating.  The  parts  are 
at  first  lubricated  with  cocoa-butter  or  vaselin,  to  avoid 
the  irritation  which  may  follow  the  friction  of  the  surface. 

The  first  process  of  massage  is  the  simple  stroking  to 
empty  out  the  lymph-channels;  the  next  process  is  directed 
to  the  deeper  tissues.  This  is  deep  kneading,  and  skill  is 
particularly  required  here.  As  the  result  of  this,  the 
muscles  are  toned  up  and  the  nerves  are  soothed,  so  that 
the  total  effect  is  that  of  sedation,  and  is  followed  by  the 
removal  of  the  fatigue  toxins,  so  that  if  necessary  it  will 
be  possible  to  undertake  work  after  the  massage  that  would 
have  been  impossible  before. 

The  operator  starts  with  the  feet.  After  both  surfaces 
of  the  foot  have  been  well  covered,  the  foot  is  firmly  grasped 
and  all  the  natural  movements  of  the  toes  and  ankles  are 
gone  through  with.  Next  the  region  of  the  ankle,  the  leg, 
which  is  treated  by  circular  friction  by  the  fingers,  by 
deep  grasping  of  the  areolar  tissues,  and,  last,  by  deep 
pinching  of  the  larger  muscle  masses.  At  brief  intervals 
upward  stroking  is  given  from  the  ankle  to  the  knee,  to 
favor  the  venous  flow  of  blood-currents.  The  same  proc- 
ess is  gone  through  with  in  the  case  of  the  hands  and  arms. 
Especial  care  is  next  given  to  the  muscles  of  the  loins,  back, 


296  PERSONAL  HYGIENE  FOR  WOMEN 

and  neck.  The  abdomen  is  then  treated.  Massage  of 
this  region  concludes  with  deep  kneading  by  the  heel  of 
the  hand  in  the  direction  of  the  colon.  The  chest  is  manip- 
ulated upward,  from  the  sternum  along  the  Hne  of  the 
pectoral  muscles.  The  face  is  not  usually  treated  in 
general  massage,  but  the  sides  of  the  neck  are  stroked  from 
above  downward,  along  the  course  of  the  internal  jugular 
veins.  Each  part  operated  upon  should  be  carefully 
covered  as  soon  as  finished. 

There  is  a  constant  rise  of  temperature  after  the  treat- 
ment, and  there  should  be  a  rapid  improvement  in  the 
tone  and  reaction  of  the  whole  muscular  system. 

The  usual  fault  in  giving  massage  is  that  too  much  is 
given  at  one  time;  the  maximum  effect  on  a  part  is  ob- 
tained in  five  minutes.  Another  mistake  is  to  employ  too 
heavy  a  hand.  A  patient  should  never  feel  bruised  or  ex- 
hausted after  the  treatment;  there  should  be  simply  a 
pleasant  lassitude  and  feeling  of  drowsiness. 

While  massage  is  not  essential  for  the  health,  it  aids 
materially  in  maintaining  good  health,  but,  in  order  to  be 
efficient,  a  skilful  masseuse  is  necessary,  as  a  considerable 
amount  of  manipulative  skill  is  essential,  which  can  only 
be  acquired  by  proper  training.  Massage,  especially 
when  taken  in  connection  with  the  Turkish  bath,  is  most 
valuable  to  remove  weariness  of  nerves  and  muscles,  as 
well  as  sHght  aches  and  pains. 

The  Balance  and  Carriage  of  the  Body. — The  erect 
position  of  the  body  is  maintained  through  the  exertion 
or  more  or  less  muscular  force.  The  base  of  the  erect 
human  body  is  the  soles  of  the  feet;  the  smaller  the  base, 
the  more  danger  of  a  fall.  The  base  is  the  smallest  when 
one  stands  on  the  toes. 

The  way  in  which  the  spinal  column  is  carried  by  the 
pelvis  determines  the  way  in  which  the  whole  body  is 
carried.  An  erect  and  graceful  carriage  in  standing  and 
walking  is  not  only  desirable  from  an  esthetic  point  of 
view,  but  it  is  most  essential  to  good  health.  Without  a 
proper  development  of  the  chest,  it  is  impossible  to  secure 


PHYSICAL  TRAINING  THE   KEY  TO  HEALTH         297 

a  normal  development  of  the  lungs  and  vigor  of  the 
heart. 

It  is  upon  the  erectness,  suppleness,  and  strength  of  the 
spinal  column  that  most  of  the  power  and  grace  of  the 
body  depend.  In  the  proper  caniage  the  natural  lines 
of  the  spinal  column  form  a  graceful  and  undulating  line, 
and  the  body  stands  erect  without  any  particular  effort. 

The  curves  of  the  spinal  column  are  of  great  value  in 
protecting  the  brain,  as  they  weaken  the  force  of  any 
shock,  which  may  be  caused  by  striking  the  bones  of  the 
feet. 

Common  Defects  in  the  Carriage  of  the  Body. — 
Owing  to  the  common  faulty  position  of  school  children 
at  their  desks,  the  sedentary  occupations  of  women,  and 
their  lack  of  physical  training  curvature  of  the  spine  is 
very  common.  A  stooping  carriage  is  the  most  common. 
The  head  is  bent  forward,  the  chest  is  sunken,  the  back  is 
round,  the  shoulder-blades  hang  outward,  the  inner  edges 
standing  out  like  wings,  and  the  abdomen  is  protuberant. 
The  muscles  are  poorly  developed  and  are  weak  and 
flabby. 

This  stooping  carriage  interferes  with  the  freedom  in 
breathing,  and  prevents  the  proper  development  of  the 
upper  part  of  the  chest  and  lungs.  Hence,  it  predisposes  to 
lung  diseases  and  tuberculosis,  a  weak  heart,  poor  circu- 
lation, shortness  of  breath,  inability  to  take  proper  exer- 
cise, and  thirmess  of  the  blood  (anemia). 

Spinal  Curvatures. — The  spinal  column  is  normally 
directly  in  the  middle  of  the  back;  any  deviation  of  this 
column  to  either  side  is  abnormal,  and  the  lungs  become 
cramped  in  a  small  and  non-distensible  bony  cage.  This 
spinal  curvature  is  most  apt  to  take  place  in  young  girls 
or  in  adult  women  after  a  severe  illness,  when  the  muscles 
of  the  back  have  become  particularly  flabby,  and,  while 
stiU  in  this  condition,  improper  attitudes  are  assumed  at 
the  desk  or  other  sedentary  occupations. 

Preventive  measures  are  of  the  utmost  importance. 
First  of  all,  comes  the  general  strengthening  of  the  body, 


298  PERSONAL  HYGIENE   FOR  WOMEN 

and  of  the  muscles  and  bones  in  particular,  by  plenty  of 
exercise  in  the  open  air. 

The  habitual  attitude  at  the  desk  and  work  should  al- 
ways be  carefully  observed,  and  in  all  sedentary  occupa- 
tions the  work  should  be  frequently  interrupted  to  take 
systematic  breathing  exercises  before  an  open  window. 

Where  spinal  curvature  has  actually  taken  place,  es- 
pecial exercises  must  be  taken  under  the  supervision  of  a 
physician  and  instmctor.  Gymnastic  exercises  must  be 
supplemented  by  outdoor  games  and  sports. 

The  Heart's  Need  of  Exercise. — The  first  essential  for 
the  maintenance  of  health,  capacity  for  work,  and  power 
of  resistance  of  disease  is  a  normally  developed  and  strong 
heart.  First,  there  must  be  secured  a  vigorous  circulation 
of  the  blood,  and  the  two  greatest  helps  to  this  are  exercise 
and  deep  breathing.  In  the  sedentary  posture  the  heart 
works  at  a  disadvantage. 

For  the  young,  exercise  of  the  heart  is  the  chief  object 
of  physical  exercises;  this  object  is  best  attained  by  ex- 
ercises of  speed,  especially  in  the  form  of  games  which 
require  rapid  movement.  In  youth  the  recuperative 
powers  of  the  heart  and  lungs  are  at  the  highest. 

An  adult  cannot  race  and  scamper  about  like  a  child 
who  plays  for  hours  together,  and  a  disturbance  of  the 
heart's  action  brought  about  by  strenuous  exercise  to  the 
point  of  fatigue  of  the  heart  is  not  so  quickly  compensated. 
On  the  other  hand,  severe  exercises  of  strength  and  endur- 
ance are  not  so  apt  to  prove  injurious  after  the  completion 
of  growth  as  they  are  in  the  growing  youth.  Up  to  the 
age  of  eighteen  years  no  feats  of  strength  or  of  endurance 
should  be  attempted.  From  eighteen  to  thirty  years  is 
the  period  of  life  when  any  kind  of  athletic  exercise  can  be 
taken,  not  only  without  any  injurious,  but  with  beneficial, 
results.  After  the  period  of  youth  new  conditions  begin 
to  make  themselves  felt,  and  more  care  must  be  exercised 
in  the  demands  made  upon  the  heart.  In  some  persons 
obesity  sets  in  before  they  have  reached  thirty  and  im- 
pedes the  action  of  the  heart.     About  the  fortieth  year  the 


PHYSICAL  TRAINING   THE   KEY  TO   HEALTH         299 

walls  of  the  arteries  begin  to  lose  their  elasticity,  they 
become  more  rigid,  and  chalk  salts  are  deposited  in  them. 
Golf  and  lawn-tennis  are  now  excellent. 

And  now  it  is  most  essential  that  exercise  be  kept  up; 
the  heart  must  still  be  trained  and  practised.  The  fibers 
of  every  muscle  degenerates  when  their  work  is  reduced  to 
a  minimum. 

Proper  health  without  proper  breathing  is  a  physical 
impossibility.  It  is  necessary  that  those  portions  of  the 
lungs  which  do  take  part  in  ordinary  breathing,  and 
which  would  atrophy  from  lack  of  use,  should  be  fully 
developed  and  kept  ready  for  suitable  exercise.  As  soon 
as  the  lungs  grow  weary  and  the  power  of  breathing  is 
exhausted,  the  most  powerful  muscles  of  the  body  give 
way.  The  pleasure  of  vigorous  walking,  especially  in 
mountainous  places,  is  alone  for  her  who  can  respond 
easily  and  readily  to  the  enormously  increased  demands  on 
the  power  of  the  respiration. 

The  direct  result  of  exercise  is  an  increased  demand  for 
oxygen  by  the  tissues,  and,  to  meet  this  demand,  respira- 
tion is  deepened  and  quickened,  and  the  beat  of  the  heart 
is  more  rapid  and  more  forcible.  But  the  phenomena  of 
increased  breathing  power  and  increased  heart  action 
benefit  other  parts  of  the  body.  At  the  commencement 
of  an  exercise  the  contraction  of  the  voluntary  muscles 
called  into  action  compresses  the  blood-vessels,  and  im- 
pels the  venous  blood  actively  toward  the  heart,  which, 
thus  stimulated,  contracts  vigorously,  and  propels  the 
blood  in  increased  quantity  toward  the  lungs.  Stimulated 
by  the  pressure  of  a  large  amount  of  venous  blood,  the  in- 
spiratory muscles  contract  and  elevate  the  bony  structure 
of  the  chest,  the  diaphragm  pushes  down  the  abdominal 
contents,  and  the  air  rushes  in  to  fill  the  vacuum  thus 
produced  and  to  supply  the  oxygen  necessary  for  the  puri- 
fication of  the  blood.  Supplied  with  this  life-giving 
element,  the  blood  is  returned  to  the  heart,  to  be  distrib- 
uted again  throughout  the  system,  and  to  restore  the  loss 
incurred  in  the  original  muscular  movements. 


300  PERSONAL  HYGIENE   FOR  WOMEN 

In  this  manner  are  not  only  the  voluntary  muscles  en- 
larged and  strengthened,  but  also  the  involuntary  muscles, 
particularly  the  heart  and  the  diaphragm.  The  increased 
activity  of  the  circulation  stimulates  other  organs  to  in- 
creased activity.  The  quantity  of  perspiration  from  the 
skin  is  more  than  doubled,  the  appetite  is  increased,  diges- 
tion is  more  perfect,  absorption  is  more  rapid,  the  hepatic 
circulation  is  more  active,  and  the  abdominal  circulation  is 
carried  on  more  vigorously. 

But,  on  the  other  hand,  actual  harm  may  be  done  if 
any  one  who  has  been  accustomed  to  lead  a  sedentary  life, 
or  who  is  not  vigorous,  suddenly  engages  in  the  more 
violent  forms  of  exercise.  In  this  extreme  exertion  the 
heart  may  be  embarrassed  by  the  respiratory  action. 
At  the  end  of  deep  inspiration  the  increased  pressure  of  the 
lungs  impedes  the  flow  of  blood  from  the  right  side  of  the 
heart,  while  the  compression  of  the  heart  itself  by  the 
distended  lungs  tends  to  overfill  the  large  veins,  and  to 
further  endanger  the  right  side  of  the  heart. 

During  general  muscular  contraction  the  arterial  pres- 
sure is  increased  at  the  outset  of  exertion,  before  the 
arteries  have  become  relaxed,  and  this  in  turn  may  lead 
to  the  engorgement  of  the  left  side  of  the  heart  and  the 
circulation  through  the  lungs.  To  these  conditions  may 
be  added  still  another;  that  is,  the  exhaustion  of  the 
respiratory  muscles,  partly  because  of  the  unusual  amount 
of  labor  thrown  upon  them,  and  partly  from  the  inade- 
quate supply  of  properly  oxygenated  blood.  If  the  dis- 
turbance of  the  pulmonocardiac  equilibrium  be  severe 
and  the  condition  unrelieved,  general  prostration  ensues 
long  before  the  muscles  engaged  in  the  work  are  exhausted. 
If,  on  the  other  hand,  the  equilibrium  be  restored,  or  when 
the  heart  and  lungs  have  been  trained  to  accomplish  the 
restitution,  the  distress  disappears,  and  the  individual  is 
said  to  have  gotten  his  second  wind. 

The  Gymnasium  in  the  Campaign  against  Disease. 
— Women,  generally  speaking,  do  not  take  sufficient  exer- 
cise.    The  trend  of  the  present  day  is  for  girls  of  the  richer 


PHYSICAL  TRAINING  THE   KEY  TO  HEALTH         301 

classes  to  lead  an  outdoor  life,  but  the  women  of  the 
middle  and  lower  classes  do  not  obtain  enough  variety 
of  exercise  or  enough  fresh  air,  and  to  the  lack  of  proper 
outdoor  exercise  is  due  their  anemic  condition,  pallor, 
flabby  muscles,  and  generally  ill-nourished  appearance. 

With  the  division  of  labor  and  the  increase  of  wealth  it 
has  become  possible  for  a  large  proportion  of  the  com- 
munity to  Hve  without  much  all-round  mental  or  physical 
activity.  As  a  consequence,  there  are  faulty  circulation  and 
defective  nutrition,  the  vital  resistance  of  the  body  is 
lowered,  and  some  of  its  various  organs  or  tissues  are  ever 
ready  to  take  on  disease.  The  lowering  of  the  tone  of  the 
body  through  dissipation,  want  of  fresh  air  and  sunshine, 
insufficient  sleep,  lack  of  proper  occupation  or  recreation, 
also  increases  the  susceptibility  of  the  body  to  disease. 

Senile  decay  is  by  no  means  only  a  matter  of  years,  but 
the  manner  of  hfe  led.  And  very  many  people  over  forty 
years  of  age  fall  into  a  condition  of  senile  decay,  merely 
because  they  do  not  take  a  sufficient  amount  of  active  ex- 
ercise. In  consequence  the  joints  stiffen,  the  muscles 
relax,  and  the  arteries  harden  prematurely.  The  prime  of 
life  would  be  very  greatly  extended,  and  old  age  delayed, 
if  women  only  continued  their  active  interest  in  work  and 
systematically  kept  up  gynmastic  exercises  and  outdoor 
sports. 

For  all  classes  of  women  provision  must  be  made,  and 
sufficient  time  afforded,  to  be  devoted  to  some  form  of 
mental  and  physical  recuperation  and  systematic  physical 
training. 

Gymnastic  versus  Athletic  Training. — The  actual 
experience  of  the  past  few  decades  has  proved  that  the 
most  effective  way  of  developing  the  mental  and  physical 
powers  and  the  constitutional  vigor  is  through  a  judicious 
system  of  gymnastics,  athletics,  and  carefully  supervised 
plays,  sports,  and  games. 

To  show  which  of  the  two  contestants  was  the  "  better 
man"  was  the  primary  object  of  all  contests,  and  this  is 
the  fundamental  source  of  the  love  of  games  and  athletics. 


302  PERSONAL  HYGIENE   FOR  WOMEN 

England  has  relied  for  her  physical  training  upon  a  large 
variety  of  games  and  sports,  instead  of  an  elaborate  system 
of  gymnastics.  The  Englishwomen  live  an  outdoor  life, 
are  great  walkers,  horseback  riders,  and  go  in  for  athletics 
and  sports,  and  we  find  that  the  English  women  have  a 
much  more  vigorous  physique  and  healthy  and  ruddy  ap- 
pearance than  their  American  sisters. 

In  Norway,  Sweden,  Denmark,  Finland,  France,  Ger- 
many, and  Italy  more  stress  is  laid  on  the  gymnastic 
training,  and  in  the  Olympic  contests,  held  in  London  in 
1908,  the  twenty-five  women  from  Denmark  afforded  a 
revelation  to  many  of  the  Americans  present. 

Medical  gymnastics  had  their  origin  in  Sweden,  and  are 
practised  largely  in  that  country  and  on  the  Continent. 

In  gymnastic  exercises  the  work  done  on  each  piece  of 
apparatus  must  be  tried  repeatedly,  in  order  to  be  learned, 
and  then  must  be  practised  assiduously,  in  order  to  be 
well  performed.  This  is  what  makes  gymnastics  so  valu- 
able as  a  means  of  physical  training  and  development. 
The  first  essential  is  to  learn  to  handle  one's  own  weight, 
and  to  have  the  muscles  of  the  body  under  complete  con- 
trol, and  much  of  the  interest  and  fascination  found  in 
practising  heavy  gymnastics  come  from  this  acquired 
power  over  one's  own  body,  and  the  ability  to  make  it  do 
the  feats  and  stunts  which  one  desires  it  to  do.  This  is 
one  reason  why  children  love  to  climb  fences,  trees,  etc., 
and  test  their  abihty  to  handle  and  master  themselves  in 
new  and  untried  situations. 

But,  in  order  that  good  and  not  actual  harm  may  be 
done,  gymnastics  must  be  carried  on  under  medical  super- 
vision. Bodily  exercises  should,  as  far  as  possible,  occupy 
the  mind  at  the  same  time.  The  fact  that  gymnastic  train- 
ing is  being  taken  up  in  our  high-schools  and  colleges  for 
girls  is  a  great  gain,  not  only  to  the  individual,  but  to  the 
race  as  well. 

The  proper  development  of  the  body,  the  clear  skin  and 
eye,  the  upright  and  graceful  carriage,  the  free  swing  of 
the  body  and  limbs  when  they  move,  give  happiness  to 


PHYSICAL  TRAINING  THE  KEY  TO  HEALTH         303 

the  possessor  as  well  as  to  the  onlookers.  The  esthetic 
advantages  of  health  are  very  considerable. 

Among  the  mental  and  moral  advantages  to  be  derived 
from  the  practice  of  exercises  and  games  are  a  greater 
amount  of  self-control,  persistence,  regularity,  prompt- 
ness, and  of  general  self-confidence.  In  the  playing  of 
games  there  is  opportunity  for  originahty  as  well  as  for 
observation.  The  unwritten  code  of  honor,  the  need  of 
accuracy — all  these  qualities  are  essential  for  a  successful 
and  happy  issue  in  the  great  battle  of  Hfe. 

The  ideal  physical  training  requires  that  systematic 
gymnastic  exercises  should  be  supplemented  by  outdoor 
games  and  sports.  Gymnastics  are  not  sufficient  for  an 
all-round  means  of  development,  because  the  movements 
are  too  regular,  too  expected,  and  too  dehberate,  but 
they  are  invaluable  for  health  and  physical  development, 
for  the  correction  of  physical  deformities,  as  a  foundation 
for  many  games  and  sports,  and  for  supplementing  the 
same.  Many  games  are  so  one-sided  that  gymnastic  ex- 
ercises are  essential  to  prevent  the  body  from  becoming 
unsymmetrically  developed,  and,  further,  gymnastic  ex- 
ercises must  invariably  be  the  foundation  for  all  games; 
no  games  can  do  what  they  are  really  capable  of  doing 
without  the  firm  foundation  of  the  best  gymnastic  train- 
ing. 

Those  exercises  and  games  should  be  selected  which  are 
the  most  fundamental  and  the  most  healthy,  which  will 
cause  the  all-round  development  of  the  body,  the  muscles, 
heart,  lungs,  chest,  a  good  condition  of  the  blood,  good 
circulation,  breathing,  digestion,  and  the  getting  rid  of 
the  waste-products. 

Such  exercises  should  teach  obedience  to  law,  self-con- 
trol, regularity,  promptitude,  and  readiness  to  meet  fresh 
conditions  or  emergencies,  persistence,  pluck,  and  the 
ready  cooperation  of  nerves  and  muscles. 

The  aim  of  gymnastic  exercises  should  be  to  secure  a 
symmetric  development  of  all  the  muscles  the  body, 
to   correct   one-sidedness,  spinal   curvatures,  and   other 


304  PERSONAL  HYGIENE  FOR  WOMEN 

physical  defects,  and  to  strengthen  all  the  muscles  of  the 
body.  In  the  gymnasium  especial  attention  must  always 
be  given  to  the  development  and  strengthening  of  the 
muscles  of  the  back  and  chest,  as  these  are  the  ones  that 
are  apt  to  be  the  most  poorly  developed  in  women,  since 
they  are  less  called  into  play  in  walking,  which  is  the  only 
exercise  that  most  women  take,  and  on  their  good  develop- 
ment and  strength  depend  the  upright  carriage  of  the 
body,  a  good  chest  capacity,  and,  hence,  good  respiratory 
capacity,  a  vigorous  heart,  and  good  circulation. 

Exercise  after  Eating. — Severe  mental  and  vigorous 
bodily  exercise  immediately  after  a  meal  retards  gastric 
digestion.  The  entrance  of  food  into  the  stomach  excites 
the  free  flow  of  gastric  juice,  which,  like  all  the  secreting 
processes,  is  dependent  upon  a  flux  of  blood  to  the  secret- 
ing glands.  Other  parts  of  the  body,  notably  the  brain, 
suffer  from  temporary  anemia,  and  hence  the  great  ten- 
dency to  drowsiness  after  eating  a  hearty  meal.  At  such 
a  time  severe  mental  work  or  vigorous  bodily  exercise  must 
necessarily  cause  a  corresponding  withdrawal  of  blood 
from  the  ahmentary  canal  to  the  brain,  or,  in  the  case  of 
physical  labor,  to  the  extremities,  in  order  to  furnish  the 
amount  of  blood  necessary  for  the  proper  performance  of 
the  functions  of  these  parts.  The  withdrawal  of  blood 
from  the  digestive  organs  has  the  effect  of  inhibiting  gastric 
digestion,  since  there  has  been  an  interruption  of  a  free 
flow  of  gastric  juice. 

We  are  safe  then  in  beheving  that  digestion  is  favored 
by  rest  of  the  stomach  before  eating,  by  gentle  exercise 
of  the  mind  and  body  after  eating,  and  by  an  undisturbed 
mental  condition. 

An  athletic  training  is  productive  of  a  more  complete 
oxidation  of  the  nitrogenous  materials  of  the  body,  and, 
therefore,  of  a  more  economic  utilization  of  these  sub- 
stances. In  those  cases  in  which  there  is  lack  of  physical 
training,  sudden  muscular  exertion  is  followed  by  a  waste 
of  nitrogenous  matter. 

The  Effect  of  Brain  Fatigue  on  Body  Fatigue  and 


-       PHYSICAL  TRAINING  THE  KEY  TO  HEALTH         305 

Vice  Versa. — Brain  fatigue  makes  the  sense  of  touch  less 
delicate.  Similarly,  muscle  fatigue  affects  brain  power; 
severe  muscular  exertion  may  bring  a  disinclination  and 
incapacity  for  brain  work.  Hard  exercise  uses  up  nerve 
force,  and  also  causes  the  circulation  of  waste-products  in 
the  blood,  and  so  the  action  of  the  brain  is  hindered.  On 
the  other  hand,  many  people  who  do  a  great  deal  of  brain 
work  know  that  an  early  morning  walk,  a  puU  on  the  river, 
is  most  refreshing  and  stimulating,  and  actually  makes 
them  more  capable  of  doing  good  brain  work;  that  is,  if 
they  are  in  fair  training  and  do  not  take  enough  exercise 
to  make  them  tired. 

It  is  beyond  question  that  a  duU  gymnastic  driU,  com- 
ing after  hours  of  hard  school  work,  may  be  a  very  heavy 
tax  on  the  brain  and  nerves,  and  can  hardly  be  a  relaxa- 
tion. Outdoor  exercises,  which  require  practically  no 
brain  work  and  a  good  deal  of  muscular  exercise,  would 
do  good,  such  as  walking,  running,  jumping,  and  various 
kinds  of  games;  while,  on  the  contrary,  exercises  of  skill 
would  be  a  serious  tax. 

The  suggestion  has  been  widely  accepted,  that  brain 
work  should  occupy  the  morning  hours,  while  technical 
education,  such  as  singing,  drawing,  and  physical  training, 
should  be  given  in  the  afternoon. 

Marks  for  Physical  Efficiency. — The  tests  suggested 
some  fifteen  years  ago  by  Sir  Francis  Galton,  the  eminent 
English  scientist,  for  assigning  marks  for  physical  qualifi- 
cations were  the  following:  First,  breathing  capacity; 
second,  strength  tests,  both  of  them  to  be  regarded  with 
reference  to  the  stature  and  the  weight;  third,  quickness 
of  response  to  a  signal,  made  either  to  the  eye  or  ear; 
fourth,  keenness  of  eye-sight;  fifth,  keenness  of  hearing; 
sixth,  color  sense. 

Dr.  Sargent,  realizing  the  usefulness  of  these  tests  in 
measuring  physical  efficiency,  included  them  in  the  phy- 
sical examinations  of  the  Harvard  students.  The  strength 
tests  consist  in  the  strength  of  each  forearm,  of  the  back  of 
the  legs,  the  dip,  the  pull  up,  and  the  lung  capacity.    The 

20 


306  PERSONAL  HYGIENE   FOR  WOMEN 

combination  of  these  seven  tests  is  known  as  the  inter- 
collegiate strength  test,  and  is  the  best  means  as  yet  de- 
vised for  measuring  the  general  muscular  strength  and  the 
respiratory  power. 

The  Advantages  Derived  from  Athletic  Sports. — 
Nothing  can  take  the  place  of  athletic  sports  to  develop 
strong  vigorous  bodies  in  girls  and  young  women.  While 
formal  gymnastics  have  both  an  educational  and  correct- 
ive value,  and  lay  the  foundation  for  athletic  sports,  they 
cannot  take  the  place  of  outdoor  sports  to  develop  organic 
vigor,  physical  and  moral  courage,  self-reliance,  judg- 
ment, self-control,  decision,  and  ethical  training,  a  consid- 
eration for  the  rights  of  others,  and  a  relaxation,  particu- 
larly from  mental  work.  Athletics  are  to  youth  what  play 
is  to  children.  Groos  tells  us  that  a  function  of  play  is  to 
furnish  an  outlet  for  exuberance  and  animal  spirits  in  the 
young. 

The  Ethical  Value  of  Sports  for  Women. — First 
come  the  benefits  to  the  individual  and  second  the  bene- 
fits to  the  community,  and  it  is  a  self-evident  fact  that 
that  which  promotes  the  highest  development  of  the  in- 
dividual raises  the  standard  of  the  community. 

The  benefits  accruing  to  the  individual  are  physical, 
esthetic,  and  psychologic;  and  as  the  result  of  the  de- 
velopment of  the  individual  along  these  lines  will  result 
the  fourth  benefit,  the  social  or  the  "community  good." 

Municipal  governments  are  beginning  to  recognize  the 
fact  that  the  maintenance  of  public  playgrounds  not 
merely  promote  the  good  of  the  individual,  but  lessen  the 
death-rate,  the  poverty  rate,  the  criminal  rate,  and  it  has 
been  found  that  the  working  capacity  of  the  people  depend 
in  some  way  upon  the  recreation  afforded  them. 

Sports  for  women  are  essential,  not  only  to  better  fit 
the  individual  for  her  place  in  life,  but  as  an  offset  to  the 
deadly  monotony  of  her  work.  The  predominating  note 
of  sports  should  be  joy,  exhilaration,  and  the  social  fea- 
tures of  games. 

Women's  sports,  like  women's  clubs,  are  and  should  be 


PHYSICAL  TRAINING  THE   KEY   TO  HEALTH         307 

run  along  different  lines  from  men's.  The  object  of  women's 
games  are  for  their  development  and  individual  good,  and 
should,  therefore,  never  be  played  before  indiscriminate 
audiences  who  pay  an  admission  fee. 

Women  have  the  same  necessity  as  children  and  men  for 
a  wholesome  physical  outlet  for  the  exuberance  of  animal 
spirits  and  energy. 

The  esthetic  value  of  games  has  been  found  to  be  ex- 
pressed in  the  improvement  of  the  personal  habits  and 
appearance,  which  indicates  a  higher  standard  of  living. 

And  the  psychologic  value  has  been  found  to  be  a 
development  of  the  mental  and  the  moral  qualities,  and  so 
the  individual  is  the  better  enabled  to  direct  her  efforts 
wisely  and  so  more  successfully  in  life's  activities. 

All  of  this  is  not  a  matter  of  theory,  but  it  is  the  uni- 
versal testimony  of  the  directors  of  the  various  athletic 
associations  for  women  all  over  the  country. 

Among  other  developments  along  the  physical  line  are 
endurance,  skill,  precision,  and  coordination.  To  be  able 
to  do  physical  things  well  has  an  ethical  value  in  the  indi- 
vidual's attitude  toward  life  in  all  its  phases. 

The  esthetic  value  lays  stress  upon  the  beauty  and  good 
form  of  games.  It  is  essential  in  playing  games  that 
women  should  stand  well,  walk  well,  run  well,  throw  well, 
and  have  a  neat  appearance.  The  manners  and  habits 
of  the  players  on  the  field  are  also  part  of  the  esthetic 
training. 

It  has  also  been  noted  that  for  reasons  largely  beyond 
her  control  the  primitive  occupations  of  women  have  been 
taken  out  of  her  hands,  and  have  forced  her,  in  order  to 
secure  a  maintenance  for  herself,  or  those  depending  on 
her  for  support,  out  of  the  home  into  the  industries  and 
occupations  of  the  world,  together  with  a  fierce  competi- 
tion which  this  necessitates.  In  other  words,  success  is 
based  upon  competition,  and  competition  is  the  keynote 
of  organized  games.  So  that  one  of  the  values  of  games  is 
to  maintain  fair,  economic,  and  cooperative  rules  of  com- 
petition.    Other  things  being  equal,  the  athletic  man  or 


308  PERSONAL  HYGIENE  FOR  WOMEN 

woman  who  has  played  according  to  the  rules  of  the  games 
is  likely  to  be  fairer  than  he  who  knows  nothing  of  clean 
sport. 

Some  of  the  mental  qualities  developed  are  observation, 
attention,  concentration,  memory,  imagination,  initiative, 
reason,  and  will  power.  These  qualities  are  most  highly 
developed  in  the  various  ball  games,  from  its  simplest 
forms  to  team  work,  as  baseball  and  basket-ball. 

The  moral  qualities  developed  are  self-control,  unselfish- 
ness, a  sense  of  honor,  self-sacrifice,  self-confidence,  fair- 
ness, democracy  of  spirit,  modesty,  and  decision.  One 
of  the  qualities  which  characterizes  a  good  player  is  that 
she  will  do  the  things  which  are  assigned  her.  Prompt- 
ness and  obedience  to  order  are  the  first  laws  in  any  game. 
Throughout  the  game  self-confidence  is  taught.  Each 
player  has  her  own  responsibilities,  decisions  must  be 
quickly  and  accurately  made,  while  overconfidence  brings 
a  sure  defeat. 

If  competition  underlies  all  games,  it  is  equally  true  that 
unselfishness  is  the  basis  of  all  team  work.  The  ability 
to  work  together  requires  at  every  point  unselfish  adjust- 
ment. One  of  the  first  things  learned  is  to  appreciate 
another's  ability,  and  the  individual  egotism,  so  marked 
in  the  beginning  of  the  work,  is  rapidly  toned  down. 

Closely  allied  with  unselfishness  is  the  spirit  of  fair  play, 
and  closely  linked  with  fairness  is  loyalty  and  a  sense  of 
honor,  the  lack  of  which  makes  girls  the  contempt  of  boys 
and  women  the  despair  of  men.  It  has  been  averred  that 
the  social  position  of  woman  and  her  dependence  upon  her 
lord  and  master  have  lead  her  to  become  indirect  and 
devious,  hence  her  lack  of  perfect  truthfulness  and  sense 
of  honor,  so  that  when  put  upon  her  honor  she  does  not 
realize  her  responsibility. 

Another  great  advantage  that  games  possess  for  women 
is  that  many  of  them,  from  their  weak  physical  condition, 
are  abnormally  sensitive  and  introspective;  they  live  too 
much  on  the  subjective  side  of  life.  While  sports  are  pri- 
marily objective,  they  afford  no  opportunity  for  analysis 


PHYSICAL  TRAINING  THE   KEY  TO   HEALTH         309 

of  feeling;  the  thought  must  be  riveted  on  the  thing  to  be 
done.  Every  girl's  school  and  woman's  club  which  pro- 
vides opportunities  for  games  and  sports  erect  barriers 
against  nervousness,  morbidity,  and  too  much  introspec- 
tion. These  qualities  which  games  develop  are  not  mas- 
culine, but  human;  qualities  needed  for  human  fellowship. 

The  Forms  of  Athletic  Games  Best  Suited  to 
Women. — Dr.  Sargent's  conclusions  as  to  the  form  of 
athletic  games  best  suited  to  women,  coming  from  a  man 
of  his  wide  observation  and  great  experience,  should  be 
more  generally  known,  and  he  says,  without  hesitation, 
that  there  is  no  athletic  sport  practised  in  which  some 
women  cannot  enter,  not  only  without  fear  of  injury,  but 
with  great  prospect  of  success.  But  the  feminine  type 
of  build,  whether  found  in  men  or  women,  is  a  handicap 
in  many  athletic  contests.  But  these  Umitations  do  not 
apply  to  girls  between  ten  and  fourteen  years  of  age. 
During  this  period  girls,  if  properly  trained,  will  often  sur- 
pass boys  of  the  same  age  in  any  kind  of  athletic  per- 
formance. Moreover,  if  girls  were  given  the  same  kind  of 
physical  training  as  boys  receive  all  through  their  growing 
and  developing  period,  they  would  be  able  to  make  a  much 
more  creditable  showing  as  athletes  when  they  became 
adult  women.  In  the  early  history  of  mankind  the  men 
and  women  lead  Hves  more  nearly  alike,  and  were  conse- 
quently more  ahke  physically  and  mentally  than  they 
have  become  subsequently  in  the  history  of  highly  civil- 
ized people. 

From  a  physiologic  standpoint,  woman  needs  exercise 
just  as  much  as  man  does,  but,  in  taking  up  athletics, 
these  must  be  regulated  on  a  different  basis.  Women,  as 
a  class,  cannot  stand  prolonged  physical  or  mental  strain 
as  well  as  men  do,  but  give  them  frequent  intervals  of  rest 
and  relaxation,  and  they  will  often  accomplish  as  much 
in  the  twenty-four  hours  as  men  do. 

From  her  physical  configuration  and  her  inability  to 
bear  prolonged  physical  and  mental  strain,  there  are 
certain  athletic  sports  and  games  that  would  be  likely 


310  PERSONAL  HYGIENE   FOR  WOMEN 

to  prove  injurious  to  most  women  if  played  in  the  form  in 
which  they  are  played  by  men.  In  this  group  are  foot- 
ball, ice  hockey,  polo,  basket-ball,  boxing,  fencing,  pole 
vaulting,  and  heavy  gymnastics.  If  these  sports  and 
games  should  be  so  modified  as  to  meet  the  peculiar  char- 
acteristics of  women,  there  are  none  of  them  that  could 
not  be  played  with  reasonable  hopes  of  physical,  mental, 
and  moral  improvement. 

The  athletic  exercises  and  games  to  which  women  are 
best  adapted,  and  in  which  they  are  most  likely  to  excel, 
are  all  forms  of  dancing,  calisthenics  and  light  gymnastics, 
archery,  lawn-tennis,  swimming,  field  hockey,  lacrosse, 
sprint  running,  bicycling,  rowing,  canoeing,  golf,  skating, 
fencing,  basket-ball,  and  all  gymnastic  plays  and  games. 

In  all  athletic  exercises  in  which  women  engage,  good 
form,  rather  than  great  records,  should  be  striven  for. 
Women  may  be  excused  for  not  being  as  strong  and  en- 
during as  men,  but  they  cannot  be  excused  for  not  being 
more  finished  and  graceful.  Good  carriage,  perfect  poise, 
self-command,  and  exquisite  grace  and  refinement  should 
enter  into  women's  athletic  performances,  and  these 
quahties  should  be  taken  into  consideration  by  the  judges 
in  making  their  awards. 


CHAPTER  IX 

SYMMETRIC  DEVELOPMENT:  GOOD  CARRIAGE 
AND  GRACE  OF  MOTION  THROUGH  GYMNAS- 
TICS AND  ATHLETICS 

Gymnasiums,  Baths,  and  Athletic  Association:  a  Fimdamental 
Part  of  a  Woman's  College  and  a  Model  Woman's  Club;  the  Vassar 
College  Gymnasium;  the  New  York  Colony  Club;  the  Yoimg  Women's 
Christian  Association;  Self-made  Good  Physique  through  Physical 
Training;  Rules  for  Taking  Exercise;  Gymnastic  Dress;  the  Con- 
figuration of  the  Foot;  Correct  Attitude  in  Standing. 

Corrective  Exercises:  Exercises  for  Developing  the  Various 
Regions  of  the  Body;  Shoulder-blade  Exercises;  Respiratory  Exer- 
cises; Exercise  for  Forward  Projection  of  Chest  and  Retraction  of 
Abdomen;  Shoulder  and  Back  Exercises;  Leg  Exercises;  Squatting 
Exercises  for  Muscles  of  Spine  and  Abdomen;  Alternate  Kneeling; 
Abdominal  Exercises;  Balancing  Exercises  for  Poise  and  Carriage; 
Balancing  Exercises  for  Extending  Depth  of  Chest;  Lateral  Tnmk 
and  Waist  Exercises;  Exercises  for  Muscles  of  Back;  Exercises  for 
Muscles  of  Abdomen;  Swimming  Exercises,  for  Back,  Thighs,  and 
Abdomen;  Rope  PuUing-exercises  for  Back,  Chest,  Waist,  Legs, 
and  Arms;  Exercises  in  Tnmk  Flexions  for  Back,  Abdomen,  and 
Legs;  Exercises  with  Chest  Weights  for  Chest,  Shoulders,  and  Arms; 
Boxing  and  Fencing;  Classic  and  Esthetic  Dancing  an  Essential 
Feature  in  Physical  Training. 

Outdoor  Exercises:  Effect  of  Walking  on  the  Heart  and  Lungs; 
Rimning;  Moxmtain  Climbing;  Swimming;  Horseback  Riding  as  an 
Exercise;  Rowing. 

Athletic  Sports:  Croquet;  Lawn-tennis;  Golf;  Hockey;  Basket- 
ball. 

Gymnasiums,  Baths,  and  Athletic  Associations 
a  Fundamental  Part  of  a  Woman's  College  and  a 
Model  Woman's  Club. — It  has  been  repeatedly  and  con- 
clusively proved,  in  a  large  series  of  cases,  that  the  phy- 
sique, carriage,  and  health  of  woman  can  be  wonderfully 
improved  by  regular  and  systematic  gymnastic  exercises, 
combined  with  outdoor  exercise  and  athletic  sports. 

3H 


312  PERSONAL  HYGIENE  FOR  WOMEN 

Briefly  stated,  the  facts  in  the  matter  are  these :  the  bony 
and  the  muscular  systems  and  the  vital  organs  are  the  same 
in  both  men  and  women,  and  hence  the  general  scheme  of 
physical  training,  which  has  been  found  to  be  so  highly 
beneficial  to  men,  would,  if  properly  modified,  be  equally 
beneficial  to  women,  and  such  a  training  for  women  is 
urged  by  the  most  competent  authorities  of  the  day. 

Two-thirds  of  the  body  weight  consists  of  bones  and 
muscles,  and  the  development,  growth,  nutrition,  and  vigor 
of  the  muscular  and  bony  system  can  only  be  maintained 
by  such  exercises  as  will  call  into  play  the  action  of  all  of 
the  muscles  of  the  body,  that  is,  the  stature,  breadth  of 
shoulders,  and  size  of  the  chest,  as  well  as  firm,  hard 
muscles,  are  dependent  on  regular  and  systematic  exer- 
cises of  every  part  of  the  body,  and  through  the  beneficial 
effects  produced  through  exercise  on  the  respiration,  cir- 
culation, and  digestion,  etc.,  the  brain,  nerves,  heart, 
lungs,  in  short,  all  the  organs  and  tissues  of  the  body,  are 
kept  in  a  healthy  condition. 

The  fife  of  the  masses  of  women  to-day  is  being  spent 
under  artificial  and  the  most  unhealthy  conditions;  for 
the  most  part  in  overheated,  ill-ventilated  houses,  with 
very  little  time  spent  in  the  open  air,  and  without  any 
knowledge  or  practice  in  games  and  outdoor  sports. 

The  occupation,  or  lack  of  occupation,  of  the  majority 
of  women  scarcely  calls  into  play  the  muscles  of  the  upper 
part  of  the  body.  This  lack  of  use  of  the  muscles  about 
the  shoulders  and  upper  part  of  the  chest  is  fatal  to  the 
development  of  the  chest  and  lungs. 

Outside  of  housewives  and  domestics,  the  majority  of 
professional,  business,  and  working  women  live  under  a 
very  high  nei-vous  tension,  with  but  a  very  slight  range  of 
physical  activity.  What  they  all  need  is  a  sufficient  variety 
of  exercises  to  call  into  play  all  the  muscles  and  the  vari- 
ous regions  of  the  body,  together  with  plenty  of  fresh  air, 
amusements,  and  recreations.  And  already  some  of  our 
large,  wide-awake,  manufacturing  establishments,  con- 
vinced that  the  practical  application  of  these  truths  in 


SYMMETRIC  DEVELOPMENT  313 

their  own  factories  would  both  improve  the  health  of  their 
employees  and  be  to  the  financial  interest  of  the  firm, 
are  now  providing  well-equipped  gymnasiums,  under  the 
direction  of  competent  instructors,  furnished  with  baths, 
resting-rooms,  restaurants,  etc.,  for  their  employees,  and 
these  experiments  have  demonstrated  that  the  improved 
quantity  and  quality  of  the  work,  the  lessened  amount  of 
sickness  among  the  employees,  more  than  compensate 
the  employers  for  the  expenditure  of  money  and  the  time 
consumed  in  physical  recreation. 

It  is  only  within  the  past  decade  that  the  great  benefits 
to  be  derived  from  a  systematic,  gymnastic  training, 
combined  with  athletic  sports  for  girls  and  women,  has 
been  generally  recognized.  To-day  all  our  best  colleges 
for  girls  and  young  women  have  well-equipped  gym- 
nasiums, with  a  corps  of  competent  instructors,  where  a 
scientific  and  systematic  course  in  physical  training  is 
given  during  the  winter  months,  supplemented  during  the 
fall  and  spring  months  by  outdoor  athletics  and  games. 
And,  further,  this  course  is  obfigatory  during  the  fresh- 
man, sophomore,  and  junior  years. 

The  result  of  the  gymnastic  and  athletic  work  done 
at  Vassar  College  for  the  past  fifteen  years  shows  a  very 
great  improvement  in  the  physical  development,  the  lung 
capacity,  and  the  general  health  of  the  students.  The 
average  lung  capacity  for  women  is  given  as  one  hundred 
and  fifty  cubic  inches;  at  Vassar  the  average  lung  capacity 
is  one  hundred  and  sixty-five  cubic  inches. 

The  Vassar  College  Gymnasium. — As  Vassar  College 
has  a  model  gymnasium,  an  unusually  fine  corps  of  in- 
structors, and  gives  the  greatest  attention  to  all  the 
details  of  the  physical  training  of  its  students,  it  may 
very  properly  serve  as  a  model  for  schools  and  women's 
clubs  throughout  the  country. 

The  instructors  all  received  their  training  at  the  Sar- 
gent Normal  School,  Cambridge,  under  the  direction  of 
Dr.  Dudley  A.  Sargent.  Hence,  it  is  naturally  run  along 
the  same  Hnes. 


314  PERSONAL  HYGIENE   FOR  WOMEN 

Gymnasium  work  is  carried  on  from  the  middle  of 
November  until  the  end  of  March.  The  gymnasium  is 
furnished  with  the  usual  apparatus  for  hght  and  heavy 
work.  The  entire  student  body  is  divided  into  four 
classes ;  each  class  meets  three  times  a  week,  and  the  period 
of  work  in  the  gymnasium  lasts  forty-five  minutes.  This 
is  followed  by  the  shower  and  needle  baths. 

The  wands  and  dumb-bells  used  are  wooden  ones,  and 
vary  in  weight  from  three-fourths  of  a  pound  to  two  and  a 
half  pounds.  Other  apparatus  that  might  be  used  in  the 
home  gymnasium  are  the  chest-weights  and  the  rowing 
machine  with  a  movable  seat. 

Instruction  in  classic  dancing  is  part  of  the  regular  gym- 
nastic work. 

The  Vassar  gymnasium  is  also  furnished  with  a  fine 
swimming  pool.  The  temperature  of  the  water  is  kept 
at  from  75°  to  80°  F.  For  beginners  it  is  necessaiy  to 
have  a  much  higher  temperature  than  for  expert  swimmers. 
Women  will  be  greatly  encouraged  to  learn  to  swim  from 
the  fact  of  the  incredibly  short  time  in  which  the  art  is 
taught  here.  Students  learn  to  swim  well  in  ten  lessons 
of  fifteen  minutes  each,  and  the  great  popularity  of  these 
lessons  renders  it  necessary  to  Hmit  the  instruction  to  ten 
lessons.  Later  in  the  season,  if  there  is  space  in  the  pool, 
the  lessons  may  be  resumed. 

Before  entering  the  gymnasium  the  girl  is  first  of  all 
carefully  examined  by  the  resident  physician  and  gym- 
nasium director,  and  the  results  of  these  examinations 
recorded. 

A  detailed  series  of  measurements  and  strength  tests 
is  made  and  recorded  on  the  gymnasium  register.  On 
completing  the  tests,  the  following  card  is  filled  out  and 
given  to  each  girl.  It  has  been  found  that  these  cards, 
kept  by  the  girls,  increase  the  interest  of  each  in  her 
development,  and  stimulate  her  to  further  exertion  to 
improve  her  physique. 


PLATE    VIII 


SYMMETRIC   DEVELOPMENT 


315 


VASSAR  COLLEGE  GYMNASIUM.— RECORD  OF  PHYSICAL 
MEASUREMENTS 


MiSB 


Examinations 


First. 

Second. 

Third. 

Fourth. 

Fifth. 

Height 

Centimeters. 

Weight 

Pounds. 

Lung  capacity  .... 

Cubic  inches. 

Girth,  chest 

Centimeters. 

Girth,  chest,  full  .   .   . 

" 

Girth,  chest,  ninth  rib. 

" 

Girth,  chest,  ninth  rib, 
full 

" 

Strength,  back  .... 

Kilos. 

Strength,  legs 

" 

Strength,  chest .... 

" 

Strength,  right  forearm 

" 

Strength,  left  forearm. 

■• 

The  instruments  needed  for  making  these  tests  are  the 
spirometer  and  two  dynamometers,  one  to  test  the  strength 
of  the  muscles  of  the  back  and  legs  and  the  other  to  test 
the  muscles  of  the  arms. 

Outdoor  sports  and  athletics  are  begun  in  the  fall,  on 
the  opening  of  the  college,  and  are  continued  as  long  as  the 
weather  permits.  The  students  then  take  up  the  regular 
gymnastic  work  until  the  spring  of  the  year,  when  athletics 
are  again  resumed.  Here  again  three  hours  a  week  are 
obhgatory.  It  should  be  stated  here  that  during  the 
menstrual  period  the  girls  are  not  only  excused  from  gym- 
nastics and  athletics,  but  absolutely  forbidden  to  take 
part  in  these  exercises. 

The  list  of  games  include  croquet,  lawn-tennis,  hockey, 
and  basket-ball.    Rowing  has  always  been  a  favorite 


316  PERSONAL  HYGIENE   FOR  WOMEN 

out-door  sport  at  Vassar.  In  1909  horseback  riding  was 
again  taken  up;  riding  lessons  were  begun  in  April,  and 
two  hundred  girls  took  lessons.  With  the  exception  of 
about  twenty,  they  all  rode  astride.  An  ordinary  man's 
saddle  can  be  used,  but  a  somewhat  narrower  saddle,  with 
a  higher  front,  is  more  comfortable. 

The  New  York  Colony  Club. — This  has  a  model  club- 
house, with  its  gymnasium,  baths,  swimming  pool,  lecture, 
and  reading  rooms,  as  well  as  bedrooms,  for  the  out-of- 
town  members  who  may  be  guests.  It  is,  therefore,  a 
natural  center  for  the  physical  and  mental  development  of 
its  members.  To  this  should  be  added  an  athletic  associa- 
tion. 

This  might  well,  then,  serve  as  a  model  for  the  women's 
clubs  over  the  country.  In  the  large  cities  the  numbers  of 
these  should  be  commensurate  with  the  population.  In 
smaU  towns  and  villages  the  entire  citizenship  should  club 
together,  as  a  great  civic  movement  affecting  the  health 
and  welfare  of  the  entire  town,  and  in  the  resulting  good 
men  would  benefit  reflexly  through  their  wives  and 
daughters. 

The  branches  of  the  Young  Women's  Christian  Associa- 
tion over  the  country  are  the  logical  centers  for  the  begin- 
nings of  this  great  movement,  just  as  the  Young  Men's 
Christian  Associations  have  been  the  centers  for  the  erec- 
tion of  gymnasiums,  the  formation  of  athletic  associations 
and  social  clubs  for  boys  and  men.  One  has  only  to  look 
at  the  magnificent  results  that  they  have  accomplished 
to  form  some  idea  of  what  might  be  done  by  a  similar 
movement  for  women. 

And  not  until  the  physique  of  woman  has  been  developed 
to  its  full  capacity  can  it  be  known  what  her  mental  capac- 
ity for  initiative,  creative,  and  inventive  genius  reaUy  is. 

Self-made  Good  Physique  Through  Physical  Train- 
ing.— It  has  not  infrequently  happened  that,  by  outdoor 
life  and  physical  training,  young  men  and  women  of  frail 
constitutions  have  developed  into  strong,  robust,  and  even 
physically  powerful  men  and  women. 


SYMMETRIC  DEVELOPMENT  317 

While  membersliip  in  a  well-appointed  gymnasium  and 
athletic  association  offers  the  most  favorable  conditions 
for  the  symmetric  and  fullest  development  of  the  body, 
and  when  possible  it  is  advised  always  to  take  at  least  a 
short  course  in  physical  training  under  the  direction  of  a 
competent  instructor,  yet  every  woman  has  it  in  her  power 
to  very  greatly  improve  her  physical  condition  without 
these  aids. 

Systematic  physical  training  should  be  begun  in  child- 
hood and  continued  all  through  life. 

Before  twelve  years  of  age  physical  training  should  be 
the  same  for  both  sexes,  and  girls  and  boys  should  have 
their  sports  and  games  together.  The  beneficial  influence 
of  this  will  be  manifest  for  both— girls  will  grow  stronger, 
less  timid,  and  more  resourceful,  and  boys  will  grow  more 
refined  and  thoughtful. 

But  even  the  case  of  the  adult  woman,  where  not  only 
physical  training  but  most  of  the  laws  of  health  have  been 
neglected,  is  far  from  hopeless.  A  poorly  developed  chest, 
round  shoulders,  a  beginning  spinal  curvature,  a  poor  car- 
riage, bad  skin,  poor  circulation,  indigestion,  constipation, 
and  low  vitality,  with  poor  powers  of  resistance  to  changes 
in  the  weather  and  environment,  are  not  insurmountable 
obstacles.  But  a  woman  in  this  condition  cannot  manage 
her  own  case.  She  must  consult  and  place  herself  under 
the  care  of  a  competent  physician. 

Physical  Examination. — Before  any  kind  of  exercise 
is  undertaken,  a  careful  examination  should  be  made  by 
a  competent  physician.  This  will  include  an  examination 
of  the  heart,  lungs,  blood,  urine  analysis,  to  ascertain  the 
condition  of  the  kidneys,  an  investigation  of  the  digestive 
apparatus,  and  the  character  of  the  stools. 

Only  in  this  way  can  the  best  results  be  obtained,  and 
all  danger  of  harm  averted  by  the  avoidance  of  those 
exercises  which,  by  being  too  violent,  would  be  actually 
harmful,  and  that,  where  needed,  corrective  exercises  may 
be  prescribed,  together  with  the  length  of  time  that  any 
one  exercise  should  be  continued. 


318  PERSONAL  HYGIENE  FOR  WOMEN 

Where  there  are  marked  symptoms  of  serious  pelvic 
disorders,  a  local  examination  should  be  made  by  a  gyne- 
cologist, and,  in  case  of  tendency  to  spinal  curvature,  the 
advice  of  an  orthopedic  surgeon  should  be  sought  at  once, 
as  otherwise  very  valuable  time  may  be  lost,  and  a  shght 
curvature,  that  could  have  been  cured  in  the  first  place,  is 
allowed  to  grow  into  a  deformity  for  Ufe. 

Two  charts  should  be  made  out;  the  first  should  be  a 
detailed  outhne  of  her  present  condition;  to  the  Vassar 
chart  already  given  should  be  added  the  physical  defects 
needing  correction,  as  round  shoulders,  poor  chest  develop- 
ment, palpitation  of  the  heart  on  exertion,  length  of  walk 
that  can  be  taken  comfortably,  also  the  time  required  per 
mDe.  As  the  strength  of  the  heart  and  lungs  increases,  as 
shown  not  only  by  the  actual  tests,  but  also  by  the  increased 
powers  of  endurance,  this  first  chart  will  be  a  matter  of 
great  encouragement  to  the  woman  and  a  great  incentive 
to  further  effort.  In  a  parallel  column  to  the  defects  should 
be  written  the  corrective  measure  for  those  defects. 
The  second  chart  should  contain  the  ideal  measurements 
and  strength  tests  for  a  woman  of  her  height  and  weight. 

Rules  for  Taking  Exercise. — The  first  things  to  be 
aimed  at  are  the  proper  ventilation  of  the  lungs,  together 
with  their  development,  and  the  strengthening  of  the 
heart.  During  the  exercise  the  windows  must  be  thrown 
wide  open,  or  the  very  object  of  the  exercise  is  defeated. 

Always  begin  with  the  simplest  exercises  and  stop  at  the 
first  sign  of  fatigue.  The  very  first  exercise  will,  therefore, 
be  the  simple  respiratory  exercises,  taken  in  bed  until  one 
acquires  some  control  of  the  muscles;  they  are  then  taken 
standing  before  a  mirror,  to  insure  the  exercises  being 
taken  correctly,  and  after  this  they  should  be  taken  before 
an  open  window.  The  respiratory  should  be  alternated 
with  the  abdominal  exercises,  and  all  of  these  should  be 
taken  for  twenty  minutes  at  a  time,  at  least  twice  a  day, 
on  rising  and  immediately  before  retiring. 

Two  hours  should  be  spent  out-of-doors  every  day. 
If  the  woman  is  weak  and  unused  to  taking  exercise,  she 


SYMMETRIC   DEVELOPMENT  319 

should  walk  until  she  feels  the  first  signs  of  fatigue,  rest, 
and  then  continue  her  walk.  If  the  weather  is  too  cold  for 
sitting  out-of-doors  the  woman  should  preferably  take  two 
short  walks  each  day,  one  in  the  morning  and  the  other  in 
the  afternoon.  For  invalids  about  ten  in  the  morning  and 
two  in  the  afternoon  are  the  best  hours  in  winter,  because 
of  the  greater  warmth  of  the  sun  at  those  times.  To  be 
effective,  exercise  out-of-doors  must  be  taken  every  day 
without  regard  to  the  weather,  since  the  system,  when  in  a 
state  of  activity,  is  less  susceptible  to  sudden  changes  of 
temperature  than  when  at  rest. 

Exercise  should  not  be  taken  after  long  fasting;  hence, 
never  before  breakfast,  nor  immediately  after  a  hearty 
meal.  An  hour  after  breakfast  or  a  light  lunch,  or  two 
hours  after  dinner,  is  the  best  time  for  regular  exercise. 

A  certain  amount  of  daily  exercise  is  essential  for  the 
preservation  of  the  health.  A  healthy  woman  should  be 
able  to  walk  five  miles  a  day,  at  the  rate  of  three  miles  an 
hour,  without  feehng  any  sense  of  fatigue. 

In  order  to  secure  the  greatest  amount  of  benefit  from 
exercise,  the  mind  should  be  entirely  free  from  care  during 
the  exercise,  so  that  the  woman  should  leave  her  cares  at 
home  and  give  up  her  mind  and  body  to  recreation  while 
she  is  out-of-doors. 

Regularity  in  taking  exercise  is  absolutely  essential 
to  secure  good  physical  development  and  to  maintain  the 
body  in  a  condition  of  health.  A  fixed  hour  should  be  set 
aside  for  this  purpose  every  day. 

No  definite  rules  can  be  given  for  the  exact  amount  of 
exercise  to  be  taken  at  one  time,  but  the  occurrence  of 
fatigue  is  the  signal  for  rest;  after  a  five  minutes'  rest, 
exercise  may  be  again  resumed,  to  be  stopped  again  at  the 
same  signal  of  fatigue.  Perhaps  three  periods  of  exercise, 
alternating  with  rest,  may  be  taken,  but,  in  order  to  do 
good  and  not  harm,  the  individual  must  always  stop  be- 
fore she  is  tired. 

A  period  of  free  exercises  should  begin  with  a  twenty 
minutes'  practice,  including  movements  for  arms,  legs, 


320        PEKSONAL  HYGIENE  FOR  WOMEN 

back,  chest,  and  abdomen,  with  especial  emphasis  on  the 
correct  poise  and  carriage  of  the  body  and  deep  breathing, 
and  it  should  terminate  with  running;  or,  if  in  a  class,  with 
a  running  game. 

For  those  of  mature  age  and  sedentary  habits  especial 
care  must  be  taken  not  to  overtax  the  heart,  always  be- 
ginning with  the  simplest  movements  and  stopping  at  the 
first  signs  of  fatigue. 

In  the  gymnasium  the  periods  of  exercise  generally 
cover  forty-five  minutes,  with  frequent  intervals  of  rest 
in  between.  Even  here  an  invariable  rule  should  be  never 
to  exercise  to  extreme  weariness. 

All  exercise  should  be  followed  by  a  shower  or  needle 
bath,  and  a  vigorous  rubbing  with  or  without  alcohol. 
Very  delicate  women  who  have  been  unaccustomed  to  tak- 
ing exercise  should  rest  on  the  couch  or  bed  for  one  hour 
before  proceeding  to  dress.  It  is  well  to  sleep,  if  possible, 
and  in  this  way  they  will  find  the  good  effects  of  the  exer- 
cise very  greatly  increased. 

Gymnastic  Dress. — The  usual  and  best  style  of  gym- 
nastic dress  is  a  bloomer  costume,  the  bloomers  coming 
above  the  knees,  long  stockings,  and  thin,  flat-soled  shoes 
without  any  heels.  The  dress  must  be  loose  at  the  neck 
and  waist,  or  it  may  be  cut  low  in  the  neck.  The  sleeves 
are  preferably  short  elbow  sleeves. 

If  the  exercises  are  taken  at  home,  the  woman  may  wear 
a  combination  undersuit,  with  stockings  and  broad-soled 
heelless  slippers.  The  lighter  the  dress,  the  better,  so  that 
there  shall  be  no  sense  of  weight  or  restriction  about  the 
neck,  waist,  or  shoulders. 

By  putting  on  her  bedroom  slippers  any  one  can  easily 
convince  herself  of  the  greater  grip  the  foot  has  on  the  floor 
when  so  clad,  and  of  the  greater  ease  and  sureness  of  the 
foot  in  walking. 

For  outdoor  athletics  a  short  skirt,  coming  just  below 
the  knees,  may  be  worn  over  the  bloomer  costume.  Ten- 
nis shoes  should  always  be  worn. 

All  rooms  used  for  exercise,  gymnasiums,  and  ball- 


SYMMETRIC   DEVELOPMENT  321 

rooms  must  be  thorouglily  ventilated  before  the  assem- 
blage of  the  people.  The  air  must  be  kept  cool,  between 
50°  and  60°  F.,  and  proper  arrangements  must  be  made  to 
keep  the  room  well  ventilated  while  in  use  without  causing 
direct  drafts. 

Well-waxed,  hard-wood  floors  are  the  best,  because 
they  can  be  kept  freest  from  dust.  Students  should  never 
be  allowed  to  enter  the  gymnasium  with  their  street  shoes 
on,  as  they  carry  with  them  much  dust  that  will  be  thrown 
in  motion  and  inhaled  during  the  performance  of  the  vari- 


es Caids. 


Astragalus, 


Metatarsal  Booo. 


Phalanges. 


Fig.  26. — Upper  surface,  bones  of  foot  (Allen). 

ous  exercises,  and  there  follows  not  only  the  irritation 
caused  by  the  inhalation  of  the  particles  of  dust,  but  also 
the  danger  of  inspiring  all  kinds  of  germs  of  disease  with 
which  the  air  is  laden. 

The  Configuration  of  the  Foot. — No  study  of  the 
correct  attitude  of  the  body  at  rest  or  in  motion  would  be 
complete  without  some  knowledge  of  the  structural  ar- 
rangement of  the  foot.  The  feet  form  the  base  of  support 
for  the  entire  body,  and  at  every  step  are  subjected  to  a 
pressure  of  from  one  hundred  to  two  hundred  pounds. 

21 


322  PERSONAL  HYGIENE   FOR  WOMEN 

This  base  is  in  the  form  of  two  arches,  a  transverse  and 
an  anteroposterior.  The  latter  is  the  most  important,  and 
has  been  subdivided  into  two  by  an  imaginary  line,  drawn 
between  the  third  and  fourth  metatarsal  bones.  The  inner 
portion  of  this  arch  is  much  more  curved  than  the  outer, 
and  forms  the  instep.  The  arch  is  supported  by  two 
piers.  The  posterior  pier  is  formed  by  the  os  calcis,  or 
heel  bone,  and  the  posterior  part  of  the  astragulus.  It 
is  shorter,  has  but  one  joint,  is  more  curved,  and  is,  at  the 
same  time,  more  solid  than  the  anterior  pier,  and  receives 
the  greater  part  of  the  weight  of  the  body.  The  anterior 
pier  includes  all  the  bones  in  front  of  the  astragulus  to 
the  junction  of  the  three  metatarsal  bones  with  the  toes. 
It  is  much  the  longer,  is  less  curved,  and  has  many  joints, 
giving  it  greater  elasticity,  and  also  enabling  it  to  diminish 
the  force  of  shocks  transmitted  to  the  arch.  The  summit 
of  the  arch  is  the  ankle. 

It  is  evident  that  the  superincumbent  pressure,  by 
flattening  the  arches,  both  lengthens  and  broadens  the 
foot.  The  anteroposterior  arch  is  further  lengthened  by 
a  turning  upward  of  the  toes,  which  form  a  hinge-joint 
with  the  instep. 

In  extension  the  foot  normally  rests  upon  the  heel, 
the  tips  of  the  metatarsal  bones,  and  the  outer  side  of  the 
sole.  In  walking,  running,  or  dancing  the  direction  of 
the  weight  upon  the  arches  is  constantly  changing,  and 
it  is  only  through  the  action  of  certain  muscles  that  the 
normal  arches  are  conserved.  This  healthy  condition  of 
the  plantar  arch  can  only  be  maintained  by  the  evenly 
balanced  action  of  those  muscles  which  surround  and 
strengthen  the  weak  parts  of  the  arch. 

Dr.  Busey's  description  of  the  foot  in  walking,  and  the 
injurious  effects  of  the  high-heeled  shoe,  is  as  follows: 
"In  walking  the  heel  touches  the  ground  first,  and  sup- 
ports the  whole  weight  of  the  body  for  a  moment.  A  little 
later  the  point  of  the  foot  touches,  and  assists  in  preserv- 
ing the  equilibrium  by  increasing  the  base.  During  the 
second  movement  of  walking  the  heel  is  raised  (see  Fig. 


SYMMETRIC   DEVELOPMENT 


323 


27,  2),  and  the  weight  of  the  body  is  shifted  more  and 
more  to  the  center  of  the  foot  and  toes,  the  latter  spread- 
ing and  pushing  the  body  forward.  This  last  is  the 
movement  which  displays  to  the  greatest  advantage  the 
suppleness  and  elasticity  of  the  articulations  of  the  foot, 
and  the  adaptat»ion  of  the  arch  to  receive  the  weight  of  the 
body,  and  to  transfer  it  to  the  distal  pier,  while  the  body 
is  being  moved  forward  by  the  same  act.     It  is  the  exe~ 


Fig.  27. — The  natural  and  artificial  positions  of  the  foot  (Camper). 


cution  of  this  movement  which  gives  to  the  gait  of  woman 
that  elegance  and  those  graceful  undulations  which  are  so 
attractive. 

"The  narrow  high-heeled  shoe,  on  the  other  hand,  by 
displacing  the  supporting  base,  causes  both  piers  of  the 
double-spanned  arch  to  strike  at  the  ground  simultane- 
ously. In  consequence  of  which  the  gait,  instead  of  being 
undulating,  is  stiff  and  hobbling,  and  the  body  advances 
by  jerks. 


324  PERSONAL  HYGIENE   FOR  WOMEN 

"When  standing  on  the  heel  bone  {NLM,  Fig.  27,  1), 
the  joint  at  K,  and  the  great  toe  C,  touch  the  support 
upon  the  Une  A-B.  When  the  feet  are  shod  according  to 
the  present  fashion,  the  Hne  A-B  is  made  to  assume 
the  concave  form  shown  in  Fig.  27,  3,  by  BTu.  The 
instep  is  made  more  convex  and  rounded,  and  the 
foot  is  actually  shortened  (see  a-h,  Fig.  27,  3).  The 
constant  elevation  of  the  heel  places  the  body  of  the 
pedestrian  in  the  same  position  as  when  standing  upon  an 
inclined  plane.  Again,  the  heel  is  so  shaped  and  located 
that  it  forces  up  the  keystone  of  the  arch  and  weakens  the 
whole  structure." 

The  Correct  Attitude  in  Standing  (See  Fig.  28). — 
The  heels  are  placed  nearly  together,  the  toes  pointed 
very  slightly  outward,  the  legs  are  rigid,  the  trunk  and 
head  are  held  erect,  and  the  shoulders  somewhat  back, 
so  that  the  chest  shall  expand  freely.  The  arms  should 
hang  easily  at  the  sides ;  the  fingers  are  slightly  bent,  with 
the  thumbs  in  front.  This  position  of  "attention"  can 
only  be  maintained  comfortably  for  a  very  short  length 
of  time,  since  the  actively  contracting  muscles  soon 
tire. 

If  the  standing  position  has  to  be  maintained  for  any 
great  length  of  time,  one  foot  should  be  placed  slightly 
in  advance  of  the  other,  the  weight  being  borne  upon  the 
straight  leg  and  the  active  supporting  foot,  the  other 
being  relatively  passive.  This  asymmetric  position  has 
the  important  advantage  that  the  two  extremities  may  be 
brought  alternately  into  play. 

The  most  common  defect  in  standing  is  that  the  entire 
weight  is  usually  borne  upon  the  same  leg,  generally  the 
right  one,  while  the  left,  being  inactive,  is  placed  out  to  one 
side;  the  habitual  maintenance  of  this  position  leads,  as 
we  shall  see  later,  to  a  tilting  of  the  pelvis  to  one  side, 
with  a  consequent  spinal  curvature  and  lowering  of  one 
shoulder. 

Persons  with  strong  feet,  especially  primitive  unshod 
feet,  mountaineers,  runners,  and  young  children,  walk 


SYMMETRIC  DEVELOPMENT  325 

with  the  inner  borders  of  the  feet  nearly  parallel  to  each 
other  and  the  direction  of  motion.  The  best  sculpture, 
both  ancient  and  modern,  shows  the  straight  supporting 
foot,  which  in  standing  is  not  necessarily  parallel  with  its 
mate,  since  the  resting  foot  may  assume  almost  any  angle 
of  divergence. 

The  influence  of  the  stability  of  a  correct  base  is  well 
illustrated  by  standing  on  one  foot  and  swinging  the  other 
leg  backward  and  forward,  which  is  much  more  difficult  if 
the  supporting  foot  be  turned  to  one  side.  A  runner  finds 
it  very  difficult  to  run  with  the  toes  turned  out,  although 
the  heels  never  touch  the  ground. 

Corrective  Exercises. — Many  of  the  most  common 
defects,  such  as  a  droopmg  head,  round  shoulders,  flat 
chest,  beginning  spinal  curvature,  etc.,  result  from  a 
weak  and  relaxed  condition  of  the  muscles,  whose  function 
it  is  to  move  and  support  these  parts.  If  the  head  is  con- 
stantly bent  forward  in  studying  and  writing  at  the  desk, 
the  muscles  at  the  back  of  the  neck  gradually  lose  then- 
tone,  and  stretch  out  like  a  piece  of  elastic  that  is  con- 
stantly kept  on  the  strain. 

The  exercises  selected  must  be  such  as  will  strengthen 
these  particular  groups  of  muscles,  and,  while  taking  the 
exercises,  the  entire  attention  must  be  concentrated  on  the 
part  being  exercised. 

Any  lack  of  symmetry  in  the  chest,  spinal  curvature, 
or  actual  weakness  of  the  lungs  will  necessitate  the  pre- 
scribing of  special  and  carefully  selected  exercises. 

As  to  the  exercises  themselves,  they  should  be  so 
arranged  as  to  bring  into  play  in  a  methodic  manner  all 
the  muscles.  All  special  and  corrective  work  must  be 
supplemented  by  general  work,  which  will  increase  the 
organic  vigor  of  the  heart,  lungs,  and  chest  necessary  to 
meet  the  vital  demands  of  the  whole  system.  Games  are, 
of  course,  most  useful  for  this  purpose,  but  the  games 
should  not  be  too  violent. 

In  most  free  exercises  the  limbs  are  used  for  weights  of 
resistance.    In  a  man  weighing  one  hundred  and  fifty 


326 


PERSONAL  HYGIENE   FOR  WOMEN 


.eervfeot 
verf«ime 


futtUtiraB 


pounds  the  arms  usually  weigh  about  ten  pounds  each 

and  the  legs  twenty  pounds. 

The  Causes  of  Round  Shoulders. 
— The  general  conditions  are  those 
that  produce  muscular  or  constitu- 
tional weakness,  as  rapid  growth, 
overwork,  the  impure  air  of  ill- ven- 
tilated rooms,  acute  illness,  near- 
sightedness uncorrected  by  glasses, 
lack  of  proper  exercise,  and  the 
wearing  of  clothing  supported  by 
suspenders  bearing  on  the  points 
of  the  shoulders,  tending  to  pull 
them  downward  and  forward,  or 
even  to  produce  a  painful  deformity 
of  the  scapula. 

It  is  the  rule  rather  than  the  ex- 
ception to  find,  with  round  shoul- 
ders, some  inequality  in  the  height. 
The  right  shoulder  is  apt  to  be  the 
lower,  owing  to  the  carrjdng  of 
burdens  on  the  right  arm.  Habitual 
standing  with  the  weight  on  the 
right  leg  contributes  to  a  good 
many  cases.  Games  in  which  the 
right  arm  is  almost  exclusively  used 
is  another  cause. 

The  Causes  of  Spinal  Curvature. 
— The  spinal  column  forms  the 
central  support  of  the  body,  and, 
for  grace  and  suppleness  of  motion, 
its  thirty-four  joints  should  be  con- 
stantly exercised,  as  well  as  the 
muscles  which  hold  it  erect  and 
support  the  head  upon  it,  as  well 
as  attach  the  shoulders,  hips,  and 

legs  more  or  less  closely  to  it.     In  brief,  all  the  muscles 

of  the  back  need  varied  and  regular  exercise  to  maintain 


rvembmc 


ibar 


fSaePttffl 


>coa/x 


Fig.  29.— The  spinal 
column  (Church  and 
Peterson). 


SYMMETRIC  DEVELOPMENT  327 

the  erect  position  of  the  body,  and  from  early  child- 
hood especial  attention  should  be  given  to  develop  and 
strengthen  this  region  of  the  body. 

The  normal  movements  of  the  spinal  column  are  flexion, 
extension,  side  bending,  and  torsion.  Flexion  and  ex- 
tension take  place,  for  the  most  part,  in  the  lumbar  and 
cervical  regions. 

Gould  believes  that  astigmatism  is  a  prominent  factor 
in  the  causation  of  spinal  curvature;  the  curvature  is 
affected  by  the  tilting  of  the  head  to  one  side  in  reading 
or  writing. 

But  a  faulty  postural  habit  is  probably  the  most  fre- 
quent cause  both  in  standing  and  at  the  desk.  When  the 
weight  is  supported  by  the  right  leg,  the  left  being  used 
merely  as  a  prop;  there  is  a  marked  C-shaped  curve  pro- 
duced, with  a  lowering  of  the  right  shoulder  and  promi- 
nence of  the  right  hip.  This  position  is  assumed  by  school 
children  for  long  periods  of  time,  and  there  is  a  consequent 
overstretching  of  the  ligaments  of  the  spine  and  hip. 
These  cases  are  generally  accompanied  by  round  shoulders 
and  flat  chest,  protrusion  of  the  abdomen,  and  rotation  of 
the  vertebrae. 

A  muscle  can  be  developed  only  by  the  active  con- 
traction and  relaxation  of  its  fibers.  Continuous  tension 
quickly  tires  and  lowers  its  tone,  so  that  exercises  given  for 
increasing  muscular  power  should  be  comparatively  quick 
and  frequently  repeated,  while  those  that  aim  at  the 
stretching  of  muscles  and  ligaments  should  be  slow  and 
long  maintained. 

In  all  cases  where  corrective  treatment  is  needed  the 
first  thing  to  be  attended  to  is  the  general  condition, 
and  the  best  hygienic  conditions  must  be  provided, 
the  general  health  inquired  into  and  attended  to.  In 
all  cases  the  eyes  should  be  examined  by  a  competent 
oculist. 

All  exercises  and  stretching  movements  should  be  given 
daily,  with  a  period  of  rest  after  three  or  four  movements, 
and  they  should  be  so  alternated  and  combined  that  no 


328  PERSONAL  HYGIENE  FOR  WOMEN 

two,  employing  the  same  muscles  in  the  same  way,  should 
follow  one  another,  and  so  cause  excessive  fatigue. 

The  Muscles  of  the  Abdomen. — These  muscles  are  most 
important  for  breathing  and  therefore  for  health,  for  the 
retention  in  their  normal  position  of  the  various  abdominal 
viscera,  for  good  digestion  and  regularity  of  the  evacua- 
tion of  the  bowels.  Sluggish  digestion  and  constipation 
are  among  the  commonest  evils  in  life,  and  they  are  gen- 
erally connected  with  relaxed  abdominal  walls  and  flabbi- 
ness  of  the  abdominal  muscles.  Active  pressure  of  the 
abdominal  muscles  on  the  viscera  massages  the  liver  and 
presses  onward  the  contents  of  the  intestines. 

The  protuberant  abdomen  may  either  be  due  to  a  faulty 
position  in  standing  or  an  excess  of  fat  in  the  great  omen- 
tum, a  membrane  intended  to  protect  the  bowels.  This 
excess  of  fat  may  be  in  turn  due  to  lack  of  exercise  or  an 
excess  of  sweets  and  starchy  foods,  and  the  reduction  of 
this  superfluous  fat  by  suitable  exercises,  properly  taken, 
together  with  the  attention  to  the  diet,  not  starvation,  is 
the  only  common  sense  and  safe  way  for  a  woman  to  reduce 
her  size. 

The  abdominal  muscles  are  used  in  bending,  in  stooping 
forward,  in  raising  up  from  the  recumbent  position,  some- 
what in  climbing,  and  in  many  other  movements.  Trunk 
bending  forward  and  backward;  lateral  flexions  of  the 
trunk ;  bending  of  the  knees  down  to  a  squatting  position, 
together  with  torsions,  and  all  exercises  derived  from  these 
types,  bring  into  play  and  exercise  the  abdominal  muscles. 

EXERCISES  FOR  DEVELOPING  THE  VARIOUS  REGIONS 
OF  THE  BODY 

The  following  list  of  free  exercises  has  been  selected 

primarily  for  developing  the  lungs  and  chest  and  correcting 
deformities,  such  as  round  shoulders,  stooping  attitude, 
and  beginning  spinal  curvature,  when  due  only  to  muscular 
weakness  and  faulty  attitude  in  standing,  sitting,  and 
walking. 


Fig.  28. — Correct  attitude  in  standing. 


Fig.  30. — Correct  attitude  in  walking.     First  position. 


Fig.  31. — Correct  attitude  in  walking.      Second  position. 


Fig.  32. — Shoulder-blade  exercise.     First  position. 


Fig.  33. — Shoulder-blade  exercise.     Second  position. 


SYMMETRIC  DEVELOPMENT  329 

While  each  exercise  calls  into  play  many  other  muscles 
than  the  ones  for  whose  development  the  exercise  is  given, 
the  exercise  is  classed  under  the  group  for  the  region  which 
it  is  especially  designed  to  benefit. 

The  dances  were  selected,  hoping  that  the  graceful 
attitude  of  the  dance  shown  would  be  a  forcible  object- 
lesson  of  what  might  be  attained  in  the  correct  poise, 
carriage,  and  grace  of  motion,  not  only  in  walking,  but  in 
all  the  movements  of  the  body. 

A  study  of  the  poses  of  the  dance  will  demonstrate  that, 
for  developing  the  arms,  strengthening  and  giving  grace 
to  the  movements  of  the  wrists,  they  are  greatly  superior 
to  the  free  exercises. 

As  the  poses  of  the  dance  can  be  readily  studied  from 
the  plates,  no  further  description  was  thought  necessary. 

Shoulder-blade  Exercises  (Fig.  32). — First  Position. 
— Stand  erect,  with  the  feet  nearly  together,  and  the 
palms  of  the  hands  brought  together  above  the  head  in 
the  manner  shown  in  the  figure. 

Second  Position  (Fig.  33) . — Throw  hands  and  forearms 
backward,  keeping  the  arms  on  a  line  with  the  shoulders, 
the  elbows  bent,  and  turn  the  palms  forward,  as  repre- 
sented in  the  second  position  of  the  figure.  Return  to 
the  first  position,  and  repeat  ten  times.  These  exercises 
strengthen  particularly  the  muscles  between  the  shoulder- 
blades,  whose  function  it  is  to  hold  the  shoulders  back. 

The  first  point  in  taking  each  exercise  is  to  learn  the 
correct  attitude  before  a  mirror;  after  this  has  been 
mastered,  the  exercises  should  be  taken  with  a  considerable 
amount  of  rapidity  and  force,  but  not  so  forcibly  that  the 
collar-bone  projects  at  its  junction  with  the  breast-bone. 
In  throwing  the  hands  and  forearms  back,  the  force  of 
the  motion  should  come  at  the  elbows,  not  at  the  hands, 
and  the  shoulders  should  be  carried  as  far  back  as  possible. 

Shoulder-blade  Exercises,  Number  2  (Fig.  34). — 
Stand  erect,  with  the  feet  nearly  together,  and  with 
the  hands  clasped  behind  the  neck,  as  seen  in  the 
figure.     Then  force  the  head  and  elbows  strongly  back. 


330  PERSONAL  HYGIENE  FOR  WOMEN 

Relax,  letting  the  elbows  come  forward.  Repeat  ten 
times. 

It  will  be  readily  seen  that  these  shoulder-blade  move- 
ments are  exercises  for  the  arms  and  chest  as  well.  The 
object  being  to  raise  and  broaden  the  chest. 

Respiratory  Exercises  (Figs.  35,  36,  37). — First  Posi- 
tion.— Stand  with  the  feet  nearly  together,  the  chin  down, 
the  arms  extended  downward,  with  the  backs  of  the  hands 
touching,  as  shown  in  the  figure. 

Second  Position. — The  chin  should  be  raised  with  the 
arms,  so  that  in  the  second  position  the  head  is  held  erect. 

Third  Position. — The  movements  of  the  hands  are  car- 
ried upward  still  further  and  separated  as  shown  in  the 
figure.  From  this  position  the  hands  should  be  brought 
downward  in  the  large  sweep  of  a  circle  to  the  original 
position. 

When  these  various  movements  have  been  accurately 
acquired,  forcible  respiratory  movements  should  be  added. 
Begin  to  inhale  forcibly  as  the  hands  are  raised,  and  hold 
the  breath  as  long  as  possible  while  the  hands  are  held 
above  the  head,  and  exhale  forcibly  while  the  arms  are  be- 
ing brought  down.  These  exercises  bring  into  play  the 
muscles  of  natural  and  forced  respiration. 

Exercises  for  Forward  Projection  of  the  Chest  and 
Retraction  of  the  Abdomen  (Figs.  38,  39). — First  Posi- 
tion.— Stand  erect,  with  the  arms  behind  the  back,  the 
hands  resting  in  the  small  of  the  back,  the  fingers  inter- 
locked, and  the  palms  facing  backward. 

Second  Position. — Straighten  the  arms,  turn  the  palms 
inward  and  then  downward,  and  lastly  out,  all  the  while 
keeping  the  fingers  interlocked.  Roll  the  shoulders  and 
arms  into  supination,  and  extend  the  neck,  as  in  the  atti- 
tude of  the  second  position  of  the  figure.  Retain  this 
position  for  a  moment,  then  reverse  slowly  back  into  the 
first  position. 

When  the  fingers  cannot  be  held  in  this  position,  start 
by  holding  a  loop  of  cord  in  the  hands,  instead  of  interlock- 
ing the  fingers. 


Fie.  34. — Shoulder-blade  exercise.     Number  2. 


Fig.  35. — Respiratory'  exercise.     First  position. 


Fig.  36. — Respiratorjr  exercise.     Second  position. 


Fig.  37. — Respiratoiy  exercise.     Tliird  position. 


Fiff.  38.- 


-Exercise  for  forward   projection  of  chest  and   retraction 
of  abdomen.     First  position. 


Fig.  39.- 


-Exercise  for  fora^ard  projection  of  chest  and  retraction  of 
abdomen.      Second  position. 


Fig.  40. — Shoulder  and  back  exercises.     First  position. 


Fig.  41. — Shoulder  and  back  exercises.     Second  position. 


Fig.  42. — Leg  exercises.     First  position. 


Fig.  43. — Leg  exercises.     Second  position. 


Fig.  44. — Squatting  exercises  for  muscles  of  spine  and  abdomen. 


SYMMETRIC  DEVELOPMENT  331 

This  exercise  is  particularly  valuable  for  projecting  the 
chest  forward,  stretching  the  shortened  ligaments,  and 
drawing  in  the  abdomen.  Care  should  be  taken  to  have 
the  chin  pressed  backward  when  the  arms  are  brought 
downward  and  turned  outward. 

Shoulder  and  Back  Exercises  (Figs.  40,  41). — First  Po- 
sition.— Stand  erect,  with  the  feet  together,  and  both  arms 
extended  on  a  plane  with  the  shoulders,  so  that  in  the  first 
position  the  left  arm  is  extended  directly  in  front  of  the 
body  and  the  right  arm  on  the  same  plane  directly  behind 
the  body.  The  arms  must  be  held  rigidly  on  the  same 
plane. 

Second  Position. — By  a  circular  movement,  the  position 
of  the  left  arm  is  assumed  by  the  right,  and  vice  versa. 
During  the  entire  movement  the  feet  must  be  kept  firmly 
planted  on  the  floor,  pivoting  at  the  hips  only,  while  mak- 
ing the  continuous  circular  movement  of  the  arms. 

These  movements  consist  in  a  torsion  of  the  body 
around  the  axis  of  the  spinal  column,  and  to  these  can  be 
added  deep  inspirations  from  left  to  right,  with  expira- 
tions from  right  to  left.  In  addition  to  the  effect  on  the 
circulation,  the  respiratory  movements  keep  up  the  nu- 
trition and  efiiciency  of  the  lungs,  which  in  old  age  undergo 
a  kind  of  atrophy,  and  also  maintain  the  elasticity  of  the 
chest-walls,  which  are  apt  to  become  stiff  through  disuse, 
and  so  interfere  with  the  movements  of  the  lungs  and 
pleura. 

Leg  Exercises  (Figs.  42,  43) .  — First  Position. — Stand 
erect,  with  the  hands  resting  on  the  hips  and  the  legs 
crossed  at  the  knees,  with  the  right  foot  in  front,  as  shown 
in  the  figure. 

Second  Position. — Swing  the  right  leg  outward  and 
around  back  to  about  eighteen  inches  back  of  the  left  foot, 
as  is  shown  in  the  second  position.  Then  swing  the  right 
leg  outward  and  around,  back  to  the  first  position. 

Reverse  the  position  of  the  feet,  and  perform  the  same 
movements  with  the  left  leg.  The  weight  of  the  body 
must  always  be  thrown  on  the  advanced  leg,  and  perfect 


332  PERSONAL  HYGIENE   FOR  WOMEN 

poise  and  balance  should  be  maintained  throughout  the 
entire  movement. 

Leg  exercises  are  useful  for  purposes  of  relieving  the 
engorged  veins  of  the  fatigued  leg,  because  the  movements 
of  such  large  masses  of  muscles  as  those  of  the  legs  and 
thighs  demand  large  supplies  of  blood,  and  consequent 
quick  action  on  the  part  of  the  heart  to  supply  it,  and  this 
blood,  pouring  swiftly  back  to  the  lungs  for  purification, 
requires  frequent  and  deeper  inspirations  on  their  part  to 
effect  the  purification;  leg  exercises  cause  greater  develop- 
ment of  the  chest  than  do  arm  exercises. 

Squatting  Exercises  for  Muscles  of  the  Spine  and 
Abdomen  (Fig.  44).  —  Stand  erect,  with  the  feet  near 
together  and  the  hands  resting  on  the  hips,  rise  upon  the 
toes,  then  sink  the  body  to  the  floor,  bending  the  knees 
sharply,  until  the  thighs  and  legs  are  doubled  upon  each 
other  and  the  weight  of  the  entire  body  is  supported  by 
the  toes.  The  trunk  must  be  maintained  perfectly  erect 
throughout  the  movement.  Then  return  to  the  original 
position.    Repeat  ten  times. 

These  exercises  strengthen  the  muscles  of  the  spine  and 
abdomen,  and  aid  in  reducing  superfluous  abdominal 
fat.  They  also  strengthen  the  ankles  and  increase  the 
flexibility  of  the  knee-joints. 

Alternate  Kneeling;  Abdominal  Exercise  (Fig.  45). 
— While  these  exercises  also  strengthen  the  muscles  of 
the  spine  and  legs,  they  are  primarily  abdominal  exer- 
cises, and  are  given  for  the  strengthening  of  the  abdominal 
muscles  and  improving  the  circulation  in  the  abdominal 
viscera. 

First  Position. — Kneel  on  the  left  knee,  with  the  face 
directed  forward,  the  right  arm  extended  perpendicularly 
up  at  the  side  of  the  head,  and  the  left  hand  resting  on  the 
hip.  The  head  and  entire  trunk  are  then  turned  slowly 
to  the  left,  the  right  arm  all  the  while  being  held  rigidly 
up  at  the  side  of  the  head,  then  returns  slowly  to  the 
original  position. 

Second  Position. — Kneel  on  the  right  knee,  with  the  face 


Fig.  45. — Alternate  kneeling;  abdominal  exercise. 


Fig.  46. — Balancing  exercise  for  poise  and  carriage. 


fill 


Fig.  47. — Balancing  exercise  for  extending  depth  of   chest.     First 

position. 


Fig.  48. — Balancing  exercise  for  extending  depth  of  chest.     Second 

position. 


i , 

Fig.  49. — Lateral  trunk  and  waist  exercise.     First  position. 


Fig.  50. — Lateral  trunk  and  waist  exercise.     Second  position. 


SYMMETRIC  DEVELOPMENT  333 

looking  directly  forward,  and  the  left  hand  extended  above 
the  head,  and  the  right  hand  resting  on  the  hip.  The  head 
and  entire  trunk  are  then  turned  slowly  toward  the  right, 
and  the  position  maintained  for  a  moment,  then  return  to 
the  original  position.     Repeat  five  times  for  each  leg. 

These  exercises  strengthen  the  abdominal  muscles, 
those  at  the  side  of  the  waist,  and  groins. 

Balancing  Exercises  for  Poise  and  Carriage  (Fig. 
46) . — These  exercises,  for  maintaining  the  equilibrium  of 
the  body  while  it  is  poised  upon  the  smallest  possible  base, 
are  among  the  most  difficult  positions  to  maintain,  requir- 
ing a  high  degree  of  coordination  of  movement.  They 
are  given  to  improve  the  poise  and  carriage  of  the  body. 

The  position  of  the  right  foot  in  the  figure  is  incorrect, 
since  the  object  of  the  movement  is  to  have  the  body 
balanced  throughout  on  the  toes  only.  Stand  erect  on 
the  tiptoes,  with  the  arms  and  hands  extended  at  the  sides 
and  above  the  head,  as  shown  in  the  figure;  then  walk 
in  the  same  position,  with  the  hands  carried  up  perpendicu- 
larly at  the  sides  of  the  head. 

Further  benefits  in  the  carriage  of  the  body  may  be  ob- 
tained by  carrying  light  weights  upon  the  head  while  per- 
forming these  exercises,  as  a  light  book. 

These  exercises,  when  properly  performed,  expand  the 
chest  and  bring  into  play  all  the  extensors  of  the  back 
and  elevators  of  the  shoulders.  They  also  round  out  the 
muscles  of  the  throat  and  neck. 

Balancing  Exercises  for  Extending  Depth  of  Chest 
(Figs.  47, 48). — First  Position. — Stand  erect,  with  the  heels 
together  and  the  hands  resting  on  the  hips.  Straighten 
out  the  right  arm,  and  extend  it  perpendicularly  up  at 
the  side  of  the  head,  and  at  the  same  time  carry  the  left 
leg  outward  and  upward  as  far  as  possible,  according  to 
the  pose  assumed  in  the  figure.  Then  lower  the  leg  and 
arm,  returning  to  the  original  position. 

Second  Position. — Stand  erect,  with  the  heels  together 
and  the  hands  resting  on  the  hips,  as  in  the  first  position. 
Then  take  the  same  movements  with  the  left  arm  and  right 


334  PERSONAL  HYGIENE  FOR  WOMEN 

leg  as  were  taken  in  the  first  position.  The  arm  and  leg 
should  be  raised  and  lowered  simultaneously. 

All  these  exercises  increase  the  vertical  diameters  of 
the  chest,  and  strengthen  the  muscles  of  ordinary  and 
forced  respiration. 

These  movements  also  relieve  the  engorged  veins  of 
fatigued  legs. 

Lateral  Trunk  and  Waist  Exercises  (Figs.  49,  50). — 
First  Position. — Stand  with  the  feet  nearly  together  and 
the  arms  extended  above  the  head ;  the  arms  are  relaxed 
at  the  wrists  and  elbows,  so  that  a  slightly  curved  line 
is  formed,  as  is  shown  in  the  figure.  First  sway  to  the 
left,  bending  at  the  waist  line  as  far  as  possible,  and  re- 
turn to  the  original  position. 

Second  Position. — The  attitude  is  the  same  as  in  the 
first  position;  sway  to  the  left  in  the  same  manner. 

These  exercises  strengthen  the  muscles  on  the  sides  of 
the  abdomen  and  the  lower  part  of  the  back,  and  are  an 
excellent  means  to  reduce  the  size  of  the  waist  in  case  of 
corpulency. 

Exercises  for  the  Muscles  of  the  Back  (Fig.  51). — 
These  exercises  may  be  taken  lying  prone  on  the  floor, 
with  the  feet  caught  under  any  piece  of  furniture  which  is 
strong  and  low  enough  to  act  as  a  cross-bar,  as  a  lounge 
or  dressing  case.  No  one  but  an  athlete  could  take  this 
exercise  without  having  the  feet  held  down. 

The  feet  should  be  held  firmly  down,  and  the  hands  may 
be  at  the  sides  or  clasped  behind  the  waist;  the  body  is 
then  slowly  raised  and  carried  backward  to  the  half -sitting 
posture,  then  gradually  lowered  to  the  original  position. 
These  movements  should  be  taken  slowly  and  not  repeated 
more  than  five  times  in  the  beginning. 

In  case  of  stooping  or  round  shoulders,  the  hands 
should  be  clasped  at  the  back  of  the  neck  instead  of  at 
the  waist. 

Raise  the  head  and  extend  the  spine,  pressing  the 
elbows  backward.  This  exercise  is  a  severe  one  on  the 
extensors  of  the  back  and  the  rotators  of  the  shoulders. 


Fig.  51. — Exercises  for  muscles  of  back. 


'^^^^^t^WMMSHJClvM 


gslBBfe"- 


Fig.  52. — Exercises  for  muscles  of  abdomen. 


Fig.  53. — Swimming  exercises:  for  back,  thighs,  and  abdomen.    First 

position. 


Fig.  54. — Swimming  exercises :  for  back,  tliighs,  and  abdomen.  Second 

position. 


Fig.  55. — Rope-pulling  exercises:  for  back,  chest,  waist,  legs,  and 
arms.     First  position. 


Fig,  56. 


-Rope-pulling  exercises:  for  back,  chest,  waist,  legs,  and 
arms.     Second  position. 


Fig.  57. — Exercises  in  lateral  trunk  flexions:  for  shoulders,  chest, 
hips,  and  legs.     First  position. 


SYMMETRIC  DEVELOPMENT  335 

Exercises  for  the  Muscles  of  the  Abdomen  (Fig. 
52). — Lie  supine  on  the  floor,  with  the  feet  firmly  fixed 
under  a  cross  bar,  or  a  piece  of  furniture  which  will  answer 
this  purpose,  and  the  hands  resting  on  the  hips,  as  shown 
in  the  figure;  slowly  raise  the  body  to  the  upright  posi- 
tion, maintain  for  a  moment,  and  return  to  the  first 
position. 

This  and  the  preceding  exercise  are  both  excellent  for 
strengthening  the  abdominal  muscles  and  reducing  an 
excessive  accumulation  of  fat  in  case  of  obesity  of  this 
region. 

Swimming  Exercises :  for  Back,  Thighs,  and  Abdo- 
men (Figs.  53,  54). — First  Position. — The  movements 
given  here  are  those  for  the  breast-stroke  in  swimming. 
Stand  with  the  feet  about  eighteen  inches  apart,  with  the 
right  foot  advanced  and  the  right  leg  straight ;  the  weight 
is  thrown  on  the  left  leg,  and  the  arms  bent  at  right  angles, 
ready  for  the  beginning  of  the  stroke,  as  shown  in  the  pose. 

Second  Position. — Shoot  the  arms  directly  forward, 
incline  the  whole  body  forward,  straighten  the  left  leg,  and 
throw  the  weight  on  the  right,  which  should  be  bent, 
as  shown  in  the  second  pose.  Then  sweep  the  hands  and 
arms  outward  in  a  horizontal  plane,  until  the  arms,  trunk, 
and  legs  are  brought  into  the  original  position. 

Then  take  the  same  exercises,  reversing  the  positions  of 
the  right  and  left  legs. 

In  taking  these  exercises  the  arms,  body,  and  legs  must 
work  simultaneously.  Special  stress  must  be  placed  on 
the  alternate  flexion  and  extension  of  the  front  and  rear 
leg  and  the  inclination  of  the  body  forward  with  each 
stroke. 

While  these  exercises  strengthen  the  muscles  of  the  arms, 
shoulders,  and  chest,  they  are  especially  intended  for  the 
extensor  muscles  of  the  back  and  thighs  and  muscles  of 
the  abdomen. 

Rope-pulling  Exercises:  for  Back,  Chest,  Waist, 
Legs,  and  Arms  (Figs.  55,  ^'o).— First  Position. — Stand 
with  the  feet  about  eighteen  inches  apart,  the  arms  ex- 


336  PERSONAL  HYGIENE   FOR  WOMEN 

tended  out  in  front  of  the  body  and  well  out  from  the  sides; 
the  right  foot  is  advanced,  and  the  weight  rests  mainly  on 
the  right  leg. 

Second  Position. — Clinch  the  hands  tightly,  as  though 
grasping  a  rope,  and  sway  to  the  left  side,  at  the  same  time 
straightening  the  right  leg;  bend  the  left  knee,  and  pull 
the  hands  toward  the  waist,  as  though  pulling  the  rope  in; 
then  extend  the  arms  and  return  to  the  first  position. 

Repeat  the  exercise  with  the  position  of  the  legs  re- 
versed. 

The  arms  must  be  extended  well  out  from  the  sides, 
bending  at  the  waist-line,  so  as  to  increase  the  reach,  and 
the  swaying  back  and  forth  must  be  done  with  perfect 
regularity. 

This  is  a  good  all-around  exercise,  as  it  brings  into  play 
and  strengthens  the  adductors  of  the  thighs,  calves,  and 
extensors  of  the  legs,  the  broad  muscles  of  the  back,  the 
muscles  of  the  chest,  waist,  and  the  flexors  and  extensors 
of  the  arms. 

Exercises  in  Lateral  Trunk  Flexions :  for  Shoulders, 
Chest,  Hips,  and  Legs  (Figs.  57,  58). — First  Position. — 
Stand  with  the  feet  eighteen  inches  apart,  with  the  right 
arm  extended  upward  and  the  left  downward,  and  the 
weight  of  the  body  thrown  on  the  right  leg,  while  the  left 
leg  is  extended  directly  to  the  side. 

Second  Position. — Change  the  weight  to  the  left  leg, 
and  bend  the  left  knee  while  the  right  leg  is  extended. 
At  the  same  time  bring  the  right  arm  down  and  carry  the 
left  up  and  sway  the  body  at  the  hips  to  the  right  side. 
The  feet  are  kept  flat  on  the  floor  during  the  entire  exer- 
cise, and  it  will  be  noticed  that  the  arm,  which  is  extended 
downward,  is  on  the  same  side  as  the  extended  leg. 

These  exercises  increase  the  flexibility  of  the  chest, 
strengthen  the  muscles  at  the  sides  of  the  waist,  and 
cause  some  massage  of  the  liver. 

Exercises  in  Trunk  Flexions :  for  Muscles  of  the 
Back,  Abdomen,  and  Leg  (Figs.  59, 60). — First  Position. — 
Stand  with  the  feet  about  six  inches  apart,  the  body  bent 


Fig.  58. — Exercises  in  lateral  trunk  flexions:  for  shoulders,  chest, 
hips,  and  legs.     Second  position. 


Fig.  59. — Exercises  in  trunk  flexions;  for  back,  abdomen,  and  legs, 
First  position. 


Fig.  60. — Exercises  in  trxink  flexions:  for  back,  abdomen,  and  legs. 
Second  position. 


Fig.   61. — Chest   weight   exercises  tor  arms   and   shoulders.     First 

position. 


SYMMETRIC  DEVELOPMENT  337 

well  forward  at  the  waist-line,  while  the  legs  are  rigidly 
extended  at  the  knees.  Increase  the  bend  gradually  at 
the  waist  until  the  tips  of  the  fingers  touch  the  floor  be- 
tween the  feet,  as  shown  in  the  pose. 

Second  Position. — From  the  first  position  carry  the  arms 
directly  forward,  upward,  and  backward  until  they  reach 
the  position  shown  in  the  second  pose,  with  the  knees  and 
ankles  flexed ;  bend  the  trunk  as  far  backward  as  possible, 
while  the  arms  are  extended  over  the  head.  Maintain 
for  a  moment,  and  return  to  the  original  position. 

These  movements  must  all  be  taken  slowly,  and  in  the 
beginning  do  not  attempt  to  go  far  back  of  the  vertical 
line.  Nearly  all  the  muscles  on  the  front  and  back  of 
the  body  are  involved  in  these  exercises,  but  the  greatest 
strain  comes  on  the  muscles  of  the  back  and  abdomen  and 
the  muscles  on  the  back  of  the  thighs.  The  bending  and 
rising  bring  into  powerful  action  the  extensors  of  the  back 
and  neck  and  the  retractors  of  the  shoulders. 

After  this  exercise  has  been  mastered,  it  can  be  used  to 
still  further  expand  the  lungs,  by  forcible  inspiration  when 
the  chest  is  in  the  most  favorable  position  for  expansion; 
retain  the  breath  while  the  trunk  is  flexed,  forcing  the  air 
into  the  cells  of  the  lungs  under  pressure.  This  last  fea- 
ture of  the  exercise  should  not  be  attempted  by  any  one 
with  weak  lungs. 

Boxing  and  Fencing. — Boxing  and  fencing  are  both 
excellent  exercises  for  the  lungs,  for  both  sides  of  the  body, 
for  balance,  for  rapidity,  for  endurance,  variety,  prompti- 
tude, and  sudden  adaptation;  for  originality,  up  to  a 
certain  point,  as  well  as  for  self-reliance  and  fearlessness. 
They  have  the  advantage  of  cheapness,  and  are  best  prac- 
tised in  the  open  air. 

Exercises  with  Chest  Weights :  for  Chest  Expan- 
sion, Shoulders,  and  Arms. — These  exercises  are  excel- 
lent for  developing  the  muscles  of  the  upper  part  of  the 
chest,  and  for  rounding  out  the  chest,  shoulders,  and  arms. 
They  are  also  good  flesh-reducing  exercises. 

The  weights  should  be  fairly  light  at  first,  beginning 
22 


338  PERSONAL  HYGIENE  FOR  WOMEN 

with  perhaps  two  and  one-half  pounds,  and  gradually  in- 
creasing until  five  pounds  are  used.  The  weights  should 
only  be  increased  with  the  increase  of  the  strength  of 
the  individual.  All  the  movements  should  be  performed 
consecutively  from  ten  to  twenty  times  each;  then  pro- 
ceed to  the  next  movement. 

In  taking  any  heavy  exercise  great  care  must  be  used 
not  to  overfatigue  the  muscles,  or  more  harm  than  good  wUl 
be  done.  As  soon  as  the  muscles  have  become  too  tired 
to  perform  any  exercise  vigorously,  it  should  be  discon- 
tinued, and  a  rest  of  a  few  minutes  taken,  when  the  exer- 
cise may  be  resumed.  When  a  point  is  reached  at  which 
the  muscles  feel  tired  at  the  commencement  of  the  exer- 
cise stop  at  once  for  the  day. 

ChestWeight  Exercises  for  Arms  and  Shoulders  (Figs, 
61,  62). — First  Position. — Face  the  chest  weights,  grasp 
the  handles  firmly,  and  hold  the  arms  straight  out  in  front 
of  the  chest.  Stand  with  the  heels  nearly  together,  and 
far  enough  away  from  the  weights  to  raise  them  a  little 
distance  from  the  floor. 

Second  Position. — Draw  the  two  handles  to  the  chest  and 
almost  under  the  arm-pits,  letting  the  elbows  and  shoulders 
go  well  back;  then  extend  the  arms.     Repeat  ten  times. 

Chest  Weight  Exercises  for  Shoulders  and  Chest 
Expansion  (Figs.  63,  64). — First  Position. — Hold  the  arms 
straight  out  in  front. 

Second  Position. — Then,  still  keeping  them  in  a  horizon- 
tal position,  throw  them  back  as  far  as  possible. 

Chest  Weight  Exercise  for  Extending  Depth  of 
Chest  (Figs.  65,  66). — First  Position. — Stand  with  the 
back  to  the  chest  weights,  palms  forward,  arms  straight. 

Second  Position. — Let  the  arms  go  past  the  sides,  back 
and  up  as  far  as  possible;  then  bring  them  down  and  for- 
ward and  return  to  first  position. 

ChestWeight  Exercise  for  Chest  Expansion  (Figs.  67, 
68). — First  Position. — Stand  with  the  back  to  the  chest 
weights,  holding  the  arms  straight  out  in  front. 

Second  Position. — Then,  keeping  them  straight  and  in  a 


Fig.  62. — Chest  weight  exercises  for  arms  and  shoulders.     Second 

position. 


Fig.  63. — Chest  weight  exercises  for  slioulders  and  chest  expansion. 
First  position. 


Fig.  64. — Chest  weight  exercises  for  shoulders  and  chest  expansion. 
Second  position. 


Fig.  65. — Chest  weight  exercises  for  extending  depth  of  chest.    First 

position. 


Fig.    66. — Chest   weight   exercises    for   extending   depth    of    chest. 
Second  position. 


Fig.  67. — Clieyt  weiglit  exercises  for  cliest  expansion.     First  position. 


Fig.    68. — Chest    weight    exercises    for    chest    expansion.     Second 

position. 


Fig.  69. — Figures  of  the  dance.     First  position  of  the  hands  and  feet. 


SYMMETKIC  DEVELOPMENT  339 

horizontal  position,  throw  them  back  as  far  as  possible. 
With  the  arms  still  extended  on  a  straight  line  with  the 
shoulders,  bring  them  forward  until  the  hands  meet  in 
front.  This  is  an  excellent  exercise  to  expand  and  develop 
the  chest. 

Classic  and  Esthetic  Dancing:  an  Essential 
Feature  in  Physical  Training. — From  earliest  antiquity 
the  dance  has  been  of  universal  practice  among  all  peoples 
of  the  earth,  both  savage  and  civiHzed,  and  it  has  been 
made  to  express  all  the  emotions  of  which  the  mind  is 
capable  of  feeling.  Dancing  held  a  prominent  position 
among  the  gymnastic  exercises  of  the  Greeks. 

The  teachers  of  physical  training  have  long  felt  that 
even  the  combination  of  gymnastics  and  athletic  sports 
left  much  to  be  desired  in  the  carriage  and  movements  of 
the  body,  so  classic  and  esthetic  dancing,  which  stands 
between  the  two,  more  closely  allied  to  gymnastics  in  its 
movements  and  to  games  in  its  spirit,  was  introduced  as 
an  additional  gynmastic  exercise,  to  harmonize  the  move- 
ments of  the  body,  and  to  produce  an  ease  of  manner  with 
a  grace  of  beauty  and  of  motion. 

Society  Dancing. — A  sharp  distinction  must  be  made 
between  the  modern  gymnastic  dancing  and  society  danc- 
ing. In  the  latter,  the  waltz  and  the  two-step  always 
require  a  partner.  The  dancing  is  ordinarily  confined  to 
the  ball-room,  with  its  poor  ventilation  and  overheated 
air;  add  to  these  the  constriction  of  the  waist,  so  that  the 
free  action  of  the  heart  and  lungs  is  interfered  with,  and 
under  these  conditions  it  may  even  prove  a  dangerous 
pastime  to  the  young  woman  with  weak  heart  or  lungs. 
As  a  physical  exercise,  the  waxed  floor  of  the  ball-room 
still  further  reduces  its  value. 

Gymnasium  or  Classic  and  Esthetic  Dancing. — For  the 
gymnasium  dancing  there  must  be,  first  of  all,  the  loose 
dress  and  heelless  slippers,  and  an  abundant  supply  of 
fresh  air  at  a  proper  temperature,  while  the  foot  grips 
the  floor  as  tenaciously  as  in  boxing  or  fencing;  a  smooth 
floor  renders  an  artistic  execution  impossible.     The  floor 


340  PERSONAL  HYGIENE   FOR  WOMEN 

should  be  rough  or  covered  with  canvas,  when  dancing 
becomes  as  good  a  developer  of  the  heart  and  lungs  as 
running  or  swimming. 

Girls  in  good  physical  condition  can  keep  up  esthetic 
dancing  for  an  hour  with  very  few  rests  or  pauses.  The 
work  done  in  one  hour  is  about  equivalent  to  a  walk  of  ten 
miles. 

The  first  steps  in  the  attainment  of  grace  of  motion  is 
to  avoid  short,  angular,  jerky  movements,  and  to  learn 
to  do  everything,  even  the  most  difficult  exercises,  with 
the  least  expenditure  of  power  and  energy.  This  implies 
considerable  muscular  strength  and  great  muscular  en- 
durance and  control.  As  soon  as  the  dancer  loses  her 
balance  or  poise,  holds  one  arm  too  straight,  and  bends  the 
other  one  at  too  sharp  an  angle,  or  puts  too  much  stress 
on  this  movement  and  too  little  on  that,  or  makes  too 
much  effort,  the  harmony  is  lost  and  gracefulness  is  not 
attained. 

The  modern  gymnasium  dancing  conforms  more  com- 
pletely with  the  requirements  of  good  exercise  than  ball- 
room dancing,  because  the  trunk,  arms,  and  legs  are  brought 
more  generally  into  action.  While  the  exercises  of  the 
feet  and  calves  are  not  so  intense  or  so  concentrated  as  in 
ballet  dancing,  the  range  and  the  extent  of  the  movement 
are  much  greater.  Not  only  are  the  shoulder,  back,  and 
chest  muscles  considerably  developed  by  the  free  use  of  the 
arms,  but  so  many  of  the  muscles  of  the  lower  part  of  the 
back,  abdomen,  and  thighs  are  used  that  greater  respira- 
tory power  is  acquired  to  sustain  the  extended  action; 
hence,  the  chest-walls  are  expanded  by  the  effort,  and  the 
abandonment  of  the  corset  during  dancing  gives  the  utmost 
freedom  to  all  respiratory  movements. 

Statistics  show  that  some  of  the  benefits  accruing  from 
a  conscientious  study  and  practice  of  aesthetic  dancing  are, 
that  it  raises  and  develops  the  chest,  lengthens  the  waist, 
and  also  reduces  its  circumference;  the  hips  are  reduced  in 
size,  the  thighs  and  calves  are  enlarged,  while  the  ankles 
are  made  smaller  and  the  insteps  are  raised  and  given  a 


Fig.  70. — Figures  of  the  dance.     Second  position  of  hands;  second 
position  of  right  foot. 


Fig.   71. — Figures   of   the   dance.     Third   position   of  hands;   third 
position  of  right  foot. 


Fig.  72. — Figures  of  the  dance.  Third  position  ("amplified") 
of  hands;  fourth  position  of  right  foot,  in  front.  N.  B. — When  the 
arms  are  not  in  motion,  the  palms  must  be  turned  down. 


Fig.  73. — Figures  of  the  dance.      Fourth  po.sition  of  hands;  fourth 
po.s 


Fig,    74. — Figures   of   the    dance.      Fifth    position    of    hands;    fifth 
jwsition  of  right  foot. 


vW^^*^ 


Fis;.  75. — Fii>:ures  of  the  dance.     Forward  balance. 


Fig.  70. — Figures  of  the  dance.     Backward  balance. 


Fig.  77. — Courtesy. 


Fig.  78. — Highland  fling. 


Fig.  79. — Hornpipe  step  "on  lieels, "  pulling  down  the  small  ropes. 


Fig.  80. — Swedish  step  from  "Kulldansen." 


Fig.  81. — Circles  ^vith  hands,  from  Spanish  dances. 


Fig.  82. — Combination  of  dance  steps.     First  position. 


Fig.  83. — Combination  of  dance  steps.     Second  position. 


Fig.  84. — Combination  of  dance  steps.     Third  position. 


Fig.  85.— On  the  toe  tips. 


SYMMETRIC  DEVELOPMENT  341 

higher  arch.  Properly  applied  and  directed,  dancing  ex- 
ercises are  even  a  cure  for  flat-foot. 

The  improvement  noted  in  thirteen  young  ladies  during 
twenty-five  days  by  M.  B,  Gilbert  is  as  follows:  The 
average  increase  in  the  normal  chest  measure,  from  half 
an  inch  to  one  and  a  half  inches;  with  the  chest  inflated, 
from  half  an  inch  to  one  and  three-fourth  inches. 

The  foundation  for  this  coordinate  work,  from  which 
an  unlimited  variety  of  the  most  valuable  developing 
exercises  is  formed,  consists  of  the  long-estabhshed  five 
positions  of  the  feet  and  five  positions  of  the  arms,  to- 
gether with  positions  of  the  whole  body,  known  as  atti- 
tudes, arabesques,  poses,  elevations,  groupings,  etc.  From 
these  precepts  are  established,  whereby  steps,  attitudes, 
and  motions  are  systematically  arranged,  according  to  the 
method,  and  in  strict  harmony  with  time  and  cadence  of 
music. 

The  freedom  given  by  such  dancing  softens  the  crude 
awkward  positions  so  universal  among  young  people;  the 
general  carriage  invariably  improves  as  the  head  goes  up 
and  the  shoulders  go  back;  a  more  elastic  tread  and  an 
easier  propelling  of  the  body  in  walking  is  gained.  Not 
only  is  the  chest  broadened  and  deepened,  and  fat  removed 
from  waists  and  hips,  and  weak  backs  strengthened,  but 
students  gain  in  quickness  of  perception,  coordination,  and 
judgment,  as  well  as  in  agility  and  power  to  keep  their 
feet  in  correct  rhythm. 

Esthetic  dancing  is  particularly  recommended  in  all 
factories,  stores,  and  schools  where  there  are  any  large 
number  of  girls  and  women  as  a  recess  exercise,  because  in 
this  way  they  get  a  great  deal  of  vigorous  exercise  in  a  very 
short  time.  It  brings  all  the  large  muscle  groups  into 
action,  causes  a  rapid  circulation  of  the  blood,  aerates  the 
lungs,  and  it  affords  the  best  possible  sort  of  a  contrast 
to  their  monotonous  and  cramped  positions;  it  is  most 
exhilarating  and  it  is  good  fun.  It  is  an  excellent  mental 
tonic  and  physical  invigorator;  it  brightens  the  day,  and 
enables  the  women  to  do  better  work. 


342  PERSONAL  HYGIENE   FOR  WOMEN 

Outdoor  Exercise. — Outdoor  exercise  must  be  regarded 
as  one  of  the  essentials  to  good  health,  and  as  such  must 
be  classed  with  food,  clothing,  bathing,  and  sleep. 

In  addition  to  the  beneficial  effects  of  exercise  on  the 
muscles,  circulation,  and  all  the  functions  of  the  body,  are 
the  soothing  effects  of  outdoor  life  on  the  nerves.  It  is 
only  out-of-doors,  in  the  parks,  in  the  country,  or  by  the 
sea  that  one  is  soothed  into  entire  oblivion  and  forgetful- 
ness  of  the  cares  of  life,  and  to  such  a  degree  that  the  in- 
dividual may  be  said  to  be  hypnotized  by  the  powers  of 
nature,  so  that  the  mind  is  almost  as  perfectly  at  rest  as  in 
a  sound  sleep. 

The  time  spent  out-of-doors  should  not  be  less  than 
two  hours  daily.  Actual  experience  of  busy  workers  will 
prove  that  not  only  is  this  time  not  lost,  but  that  actually 
more  and  better  work  can  be  done  in  the  day,  and  that  the 
resulting  improvement  in  the  general  health  will  be  so 
great  that  much  less  time  will  be  lost  through  indisposition 
and  actual  sickness,  so  that  the  daily  outdoor  exercise 
will  be  found  to  be  a  great  economic  gain. 

Outdoor  exercises,  such  as  walking,  running,  swimming, 
and  hill  and  mountain  climbing,  possess  the  very  great 
advantage  that  indulging  in  them  demands  no  expense, 
and  are,  therefore,  open  to  all.  All  these  exercises  de- 
velop the  lungs  and  chest  and  strengthen  the  heart,  and 
are,  therefore,  classed  under  exercises  of  endurance. 

The  Effect  of  Walking  on  the  Heart  and  Lungs. — 
In  a  slow  walk  the  respiratory  action  is  almost  double  the 
ordinary  amount;  in  walking  at  an  ordinary  pace,  that  is, 
about  three  miles  an  hour,  it  is  four  times  as  great ;  while 
in  a  vigorous  or  hasty  walk,  that  is,  at  a  rate  of  from  four 
to  six  miles  an  hour,  it  is  from  seven  to  nine  times  as 
great. 

The  change  of  speed  from  three  to  five  miles  an  hour 
elevates  an  automatic,  listless  occupation  into  a  vigorous 
exercise,  employing  many  new  muscle  groups  and  stimu- 
lating the  heart,  lungs,  and  skin,  while  the  change  from  a 
smooth,  level  road  to  the  broken  ground  of  the  mountain- 


SYMMETRIC  DEVELOPMENT  343 

side  may  be  dangerous  for  many  a  one  who  is  able  to  walk 
at  a  moderate  speed  on  level  ground. 

In  walking  the  clothing  must  be  sufiiciently  loose  not  to 
interfere  with  the  more  rapid  respirations  and  the  increased 
action  of  the  heart.  When  the  heart  cannot  keep  pace 
with  the  demanded  speed  of  the  circulation,  a  "stitch" 
ensues,  and  getting  one's  second  wind  means  that  the  heart 
has  succeeded  in  accommodating  itself  to  the  strain.  Too 
great  a  "stitch,"  resulting  in  absolute  breathlessness, 
is  a  warning  that  must  not  be  disregarded. 

This  increase  in  the  respiratory  action  is  important, 
as  compared  with  the  brief  and  transient  increase  from 
exercise  with  apparatus,  because  a  quick  walk  can  easily 
be  kept  up  for  several  hours. 

The  fatigue  is  small,  because,  in  the  first  place,  of  the 
abundant  supply  of  oxygen;  the  will  is  scarcely  used,  and 
walking  is  almost  automatic,  partly  because  the  muscle 
areas  used  are  large,  and  each  movement  prepares  for  the 
next.  Walking  is  a  heart  and  lung  exercise  of  a  very  ex- 
cellent sort. 

The  Effect  of  Walking  on  the  Movements  of  the  Blood  in 
the  Legs. — The  circulation  of  the  blood  depends  on  the 
pumping  of  the  heart,  which  is  in  turn  affected  by  the  suc- 
tion action  of  the  lungs  and  the  muscular  movements  of 
contraction  and  relaxation  which  go  on  rhythmically. 
"''^"J^ile  in  prolonged  standing  the  veins  of  the  legs  become 
fuller,  and  the  circulation  of  blood  in  them  more  sluggish, 
and  by  the  laws  of  gravitation  the  blood  is  kept  down  in 
them.  Hence  also  in  walking  slowly  with  short  steps  the 
legs  remain  overfull  of  blood  and  become  heavy.  Instead 
of  being  quickened,  the  circulation  is  actually  hindered, 
for  the  waste-products  are  not  carried  away  quickly  enough. 
Hence,  slow  walking  soon  causes  a  feeling  of  fatigue,  while 
the  vigorous  walker,  going  along  with  long  strides,  keeps 
fresh. 

Rules  for  Long  Walks. — In  walking,  not  only  the  dis- 
tance should  be  taken  into  account,  but  the  character  of 
the  road  and  the  incline  of  the  ascent,    A  distance  that 


344  PERSONAL  HYGIENE   FOR  WOMEN 

could  be  easily  covered  on  a  smooth,  level  highway  may 
mean  double  the  expenditure  of  muscle  and  nerve  force  if 
the  ground  is  sandy  or  veiy  damp.  Other  hindrances  to 
be  taken  into  consideration  are  opposing  winds,  not  only 
because  of  the  resistance,  but  also  because  of  the  inhala- 
tion of  dust  and  rain. 

The  walk  should  be  occasionally  broken  for  short  periods 
of  rest.  The  pauses  should  be  short,  about  five  minutes, 
and  during  this  time  the  body  should  be  erect.  Experi- 
ence proves  that  sitting  down  makes  one  more  tired  on 
getting  up  again.  A  short  halt  should  be  made  before 
climbing  a  steep  ascent,  so  as  to  begin  with  fresh  strength 
and  easy  breathing,  as  this  means  increased  work  for  the 
heart  and  lungs. 

In  starting  out  for  a  walk,  one  should  begin  slowly,  and 
gradually  increase  the  pace,  and  in  returning  the  same  rule 
should  be  observed. 

Running. — The  force  exerted  in  running  is  enormous. 
In  running  it  is  the  length  of  the  step  more  than  anything 
else  which  increases  the  speed  of  the  run ;  hence,  the  runner 
should  learn  to  take  long  steps.  But  the  greatest  speed 
can  only  be  kept  up  for  a  limited  time;  the  distance  is  one 
hundred  yards. 

Running  is  the  most  effective  of  all  exercises  of  speed, 
and,  like  all  exercises  of  speed,  can  be  changed  into  one  of 
endurance  by  a  certain  moderation  in  the  pace.  By 
running  the  heart  and  lungs  are  developed  more  than  by 
any  other  exercise. 

Age  Limit  for  Running. — All  ages  are  not  equally  well 
adapted  for  running:  they  do  not  all  share  in  its  good 
results.  Running  is  best  for  all  young  people,  before  and 
at  the  age  of  puberty.  Running  is  then  quite  a  necessity. 
The  growing  child  is  always  ready  for  a  run.  From  the 
fortieth  year  on  running,  as  an  exercise  of  speed,  becomes 
less  and  less  desirable,  and,  when  the  organs  of  circula- 
tion or  breathing  are  impaired,  it  must  be  absolutely 
forbidden. 

In  running  always  begin  slowly — running  moderately, 


SYMMETRIC   DEVELOPMENT  345 

for  instance,  for  fifty  feet ;  then  increase  the  speed  gradually, 
but  when  running  for  exercise,  never  speed  to  the  utmost,  as 
this  is  not  necessary  for  the  benefits  of  the  exercise. 
Always  close  the  run  with  the  same  moderation  with  which 
it  was  commenced ;  that  is,  never  stop  short,  as  this  sudden 
arrest  of  action  gives  a  most  undesirable  shock  to  the  heart. 
The  movements  of  running  may  easily  be  imitated  in  the 
house,  while  standing  in  one  place,  and  simply  lifting  the 
feet  in  the  same  quick  alternation  from  the  floor. 

Mountain  Climbing. — The  advantages  of  mountain 
climbing  are  manifold.  The  weight  of  the  body  has  to  be 
carried  up  a  certain  height.  To  accomplish  this  the  work 
of  the  muscles  is  increased;  the  breathing  must  be  deeper 
to  satisfy  the  increased  demands  for  oxygen;  fresh  air  is 
admitted  into  the  apices  of  the  lungs,  which  do  not,  as  a 
rule,  participate  in  respiration.  A  more  powerful  action 
of  the  heart  takes  place,  but  care  must  be  taken  that  this 
is  not  carried  too  far.  Slow  climbing,  without  any  un- 
necessary waste  of  energy  and  with  appropriate  pauses, 
to  allow  the  heart  to  recover,  is  advantageous.  One 
should  not  talk  too  much  while  climbing.  The  dress 
should  be  suitable ;  the  neck  must  be  free  and  the  shoulders 
not  heavily  weighted,  so  that  they  may  be  drawn  back 
and  the  chest  fully  expanded. 

Swimming. — Of  all  outdoor  exercises  for  women, 
swimming  is  one  of  the  most  perfect.  It  not  only  calls 
into  vigorous  action  most  of  the  muscles  of  the  body,  but 
spares  many  of  those  muscles  which  are  so  commonly 
overworked,  most  of  the  work  being  performed  by  muscles 
which  are  so  little  used  as  to  have  become  weak  and 
flabby. 

For  instance,  the  extensors  of  the  fingers  and  the  hand, 
that  are  so  constantly  stretched  in  sewing  and  writing, 
are  in  constant  use  in  swimming,  while  the  corresponding 
flexors,  the  slaves  of  the  needle  and  the  pen,  are  relaxed. 
Again,  the  muscles  passing  from  the  shoulder-blades  to 
the  trunk,  on  which  depends  much  of  the  erect  carriage 
and  strength  of  the  chest,  which  have  become  wasted  from 


346  PERSONAL  HYGIENE   FOR  WOMEN 

disuse  while  the  woman  sat  at  the  desk  or  bent  over  her 
sewing,  are  the  very  muscles  by  which  the  movements 
of  the  upper  half  of  the  body  are  executed,  while  all  the 
muscles  of  the  lower  extremity  are  brought  into  use. 
Of  especial  value  is  the  free  movement  of  the  hip-joint,  a 
joint  that  is  seldom  moved  with  any  degree  of  freedom 
from  the  time  a  girl  leaves  climbing  trees,  unless  she  has 
the  advantage  of  special  gymnastic  training.  The  vigor- 
ous action  demanded  of  the  respiratory  muscles  greatly 
increases  the  chest  capacity. 

The  body  is  lighter  than  the  water,  and  is  perfectly 
supported  by  it,  so  the  weight  is  taken  off  the  spine,  and 
the  muscles  of  the  back  are  relieved  from  their  normal 
state  of  tension.  The  head  is  the  only  part  of  the  body 
that  is  held  up  by  muscular  action,  and,  in  floating,  even 
this  is  supported  by  the  water. 

The  disadvantages  arise  from  the  fact  that  the  tempera- 
ture of  the  water  is  very  much  below  that  of  the  body, 
so  that  there  is  a  greatly  increased  conduction  of  heat  from 
the  body,  and,  unless  this  loss  is  made  good  by  exercise, 
there  is  very  great  danger  of  a  chill.  In  most  persons  a 
prolonged  stay  in  cool  or  cold  water  produces  a  liability 
to  cramp. 

During  the  month  of  August  the  temperature  of  the 
ocean  reaches  its  maximum  of  66.65°  F.  This  is  about 
32  degrees  below  the  temperature  of  the  body.  Upon 
entering  the  water  the  first  effect  noticed  is  a  sensation  of 
cold ;  this  varies  with  the  susceptibility  of  the  individual, 
and  the  difference  between  the  temperature  of  the  water 
and  the  surrounding  air.  The  skin  assumes  the  appear- 
ance of  "goose-flesh,"  the  face  is  pale  and  anxious,  and 
the  lips  are  blue;  the  pulse  decreases  in  frequency,  a  sense 
of  oppression  is  manifest,  and  there  may  be  spasmodic 
shivering;  that  is,  the  first  effect  of  immersion  is  to  cause 
a  contraction  of  the  blood-vessels  of  the  surface  of  the 
body.  This  should  be  quickly  followed  by  a  secondary 
reaction,  in  which  there  is  a  sensation  of  warmth,  a  quick- 
ened pulse,  and  an  increase  of  energy.     When,  by  taking 


SYMMETRIC  DEVELOPMENT  347 

the  proper  precautions,  this  reaction  does  not  occur,  it  is  a 
contraindication  to  sea-bathing  and  swimming. 

If  the  immersion  has  been  too  prolonged,  there  is  a 
second  sensation  of  chilliness,  a  signal  that  the  bather 
must  leave  the  water  at  once. 

The  best  time  for  bathing  is  between  eleven  o'clock  in 
the  morning  and  four  in  the  afternoon,  depending  on  the 
tide.  No  one  should  go  into  the  water  within  two  hours 
after  meals,  nor  should  she  on  leaving  the  bath  proceed 
at  once  to  the  table,  since  digestion  draws  the  blood  from 
the  periphery  to  the  stomach,  and  to  eat  immediately 
after  bathing  is  to  lose  most  of  the  benefit  of  the  saline 
treatment. 

All  should  avoid  cold-water  bathing  when  fatigued, 
and  swimmers  ought  to  pay  especial  attention  to  this  point, 
on  account  of  the  demand  they  are  going  to  make  on  their 
muscular  system;  and  on  no  account  must  one  enter  the 
water  when  in  a  perspiration;  a  moderate  walk  along  the 
shore  should  be  taken  until  the  perspiration  has  subsided. 
These  precautions  are  of  the  highest  importance,  and  dis- 
regard of  them  may  prove  fatal. 

Enter  the  water  quickly  until  it  reaches  the  waist,  then 
plunge  headlong,  or  cover  the  body  to  the  neck.  Care 
should  be  taken  to  wet  the  chest  and  abdomen  immedi- 
ately on  entering  the  water,  since  these  parts  are  the  most 
sensitive  to  the  impression  of  cold. 

Every  one  should  learn  to  swim,  and  those  who  cannot 
must  move  the  arms  and  legs  about  vigorously.  The 
duration  of  the  bath  should  depend  on  the  state  of  the 
health  of  the  individual,  on  the  state  of  the  weather,  and 
on  whether  the  water  is  rough  or  calm.  The  average  dura- 
tion of  the  time  spent  in  the  water  should  be  from  three  to 
fifteen  minutes,  the  latter  being  the  maximum  time  for 
any  one.  No  benefit  will  accrue  from  spending  a  longer 
time  than  this  in  the  water,  and  much  harm  may  result. 

The  sea-bath  should  be  followed  by  moderate  exercise, 
in  order  to  insure  a  perfect  reaction,  and  to  aid  in  expend- 
ing the  superfluous  energy  which  sea-water  imparts. 


348  PERSONAL  HYGIENE  FOR  WOMEN 

Swimming  and  sea-bathing  should  be  avoided  by  per- 
sons who  have  weak  hearts  and  a  poor  circulation,  in 
whom  the  reaction  after  a  plunge  into  cold  water  is  never 
well  established.  Also  by  persons  with  heart  or  kidney 
disease,  and  by  all  feeble  and  old  persons. 

Persons  with  feeble  constitutions,  but  with  no  actual 
disease,  as  in  various  forms  of  nervous  disorders,  insomnia, 
etc.,  generally  derive  marked  benefit  from  sea-bathuig. 

Persons  who  are  weak  should  walk  and  not  plunge  into 
the  water.  As  in  all  other  exercises,  a  determination  on  the 
part  of  the  weak  to  equal  the  strong  is  a  fertUe  cause  of 
mischief. 

Horseback  Riding  as  an  Exercise. — The  advantages 
claimed  for  horseback  riding  are  that  it  acts  on  nearly 
every  muscle  of  the  body,  while  the  mind  is  interested  and 
refreshed.  An  insuperable  disadvantage  to  the  majority 
of  women  living  in  large  towns  and  cities  is  the  enormous 
cost  of  the  exercise. 

The  value  of  horseback  riding  for  women  has  been  greatly 
diminished  by  the  very  faulty  position  caused  by  the  side- 
saddle, which  produced  a  cramped  position  of  the  body  and 
a  tendency  to  lateral  curvature  of  the  spine.  Then,  too, 
women  ride  too  tightly  corsetted,  thereby  preventing  much 
good  that  would  otherwise  acciTie  to  the  circulation  and 
digestive  organs. 

When  the  woman  rides  astride,  the  body  is  held  erect 
and  in  a  natural  position,  and  she  sits  much  more 
firmly  on  her  horse  and,  if  not  corsetted,  it  becomes  an 
exhUaratuig  and  delightful  form  of  exercise.  The  best 
results  wUl  probably  be  found  in  a  neurasthenic  class  of 
women,  who  are  not  strong  enough  to  take  more  active 
exercise,  and  for  them  it  will  be  of  decided  therapeutic 
value  to  both  mind  and  body. 

Rowing. — This  is  one  of  the  most  beneficial  of  exercises; 
it  has  the  advantages  of  scenery,  freedom  from  dust,  and 
companionship ;  it  exercises  equally  both  sides  of  the  body 
and  most  of  the  muscles.  It  is  an  excellent  exercise  for 
strength,  rapidity,  and  endurance. 


SYMMETRIC   DEVELOPMENT  349 

In  correct  and  graceful  rowing  there  is  a  pendulum-like 
movement  from  the  hips.  The  rower  should  sit  with 
the  trunk  fully  extended,  the  head  up,  the  eyes  to  the  front, 
the  chest  thrown  forward,  and  the  weight  of  the  trunk 
equally  distributed  upon  the  two  sides  of  her  seat.  The 
feet  rest  against  the  stretcher,  the  two  hands  should  be 
near  together,  and  should  be  held  symmetrically  at  an 
equal  distance  from  the  body. 

Stretching. — The  body  and  extended  arms  are  brought 
forward  as  far  as  possible.  The  spinal  column  should  be 
kept  extended,  not  bent  so  as  to  make  a  crooked  back, 
and  the  trunk  should  be  thrown  forward  from  the  hip- 
joints.  When  the  stretch  has  reached  its  forward  limit, 
the  oar  is  dipped  into  the  water  just  far  enough  to  cover  it; 
then  immediately  the  pull  begins,  and  it  must  be  continued 
evenly  to  the  end. 

The  Pull. — The  body  rises  erect  from  the  hips  and 
swings  backward.  The  hands  should  not  reach  the  front 
of  the  chest  until  the  body  has  passed  the  perpendicular 
and  is  sinking  back.  When  the  pull  is  finished,  the  hands 
are  dropped  and  suddenly  bent  toward  the  wrists.  This 
lifts  the  oar  out  of  the  water,  and  keeps  its  lower  surface 
parallel  with  it;  during  the  stretching  forward,  the  oar 
is  kept  parallel  with  the  water,  so  that  it  has  not  much 
resistance  from  the  air. 

The  muscles  brought  chiefly  into  play  are  the  long 
muscles  of  the  back  in  the  backward  swing,  and  the  ab- 
dominal muscles  in  the  forward  swing.  But  the  muscles 
of  the  pelvis,  thighs,  and  legs  all  have  to  work,  likewise  the 
muscles  of  the  arms,  chest,  and  shoulders.  And  it  is  one 
of  the  best  exercises  for  developing  the  lungs  and  chest,  as 
well  as  of  strengthening  the  heart.  Fatigue  will  be  felt 
most  in  the  muscles  of  the  legs,  hips,  and  arms,  but  the 
exertion  is  so  well  distributed  that  it  causes  much  less 
fatigue  than  would  otherwise  be  the  case. 

Athletic  Sports. — Athletic  sports  possess  three  distinct 
advantages — they  are  played  out-of-doors,  and  give  an 
incentive  to  taking  the  proper  amount  of  exercise;  they  are 


350  PERSONAL  HYGIENE   FOR  WOMEN 

all  team  games,  and  so  develop  the  social  and  cooperative 
spirit ;  and  last,  but  by  no  means  least,  they  afford  a  great 
deal  of  amusement  and  real  recreation. 

Formal  and  systematic  gymnastics  are  essential  for  the 
development  of  the  body  and  the  correction  of  its  defects; 
out-of-door  exercise  is  excellent,  but  the  solitary  walk, 
climb,  swim,  or  row  leaves  much  to  be  desired,  while  in 
walking  especially  the  mind  is  free  to  pursue  the  same 
trains  of  thought  which  with  it  was  occupied  at  the  desk, 
and  so  it  fails  to  be  properly  refreshing  to  the  mind  and 
body.  Whereas  in  all  athletic  sports  the  ego  has  to  be 
pushed  into  the  background,  with  all  its  interests,  the 
day's  work  left  behind,  and  the  entire  attention  concen- 
trated on  the  play.  This  is  a  very  distinct  advantage  to 
the  individual. 

Women  at  all  ages  take  themselves  and  life  too  seriously. 
This  is  in  all  probability  due  to  a  defective  early  education; 
between  the  long  school  hours,  home  study,  housework, 
and  sewing,  they  had  neither  time  nor  opportunity  to  cul- 
tivate a  love  for  play  and  games,  and  so  the  play  instinct 
was  not  developed,  and  if  not  developed  in  youth,  the 
chances  are  that  it  never  will  be.  In  middle  and  advanced 
age,  when  the  stress  and  storm  are  at  their  height,  nothing 
is  so  sure  a  restorative  to  overtaxed  brains  and  over- 
wrought nerves  as  games,  sports,  and  a  love  of  fun. 

As  a  result  of  our  unnatural  mode  of  life  in  youth,  it  has 
come  to  pass  that  American  women  especially  have  been 
defrauded  out  of  their  birthright  of  the  love  of  games  and 
sports.  Athletic  games  and  sports  are  as  essential  to  a 
scheme  of  education  as  are  reading,  writing,  and  arith- 
metic. 

Other  distinct  advantages  accruing  to  athletic  games 
are  that  here  the  individual  becomes  acquainted  with  her 
powers  and  weaknesses.  In  formal  gymnastics  the  move- 
ments follow  each  other  in  a  regular  sequence,  through 
lines  already  carefully  laid  out;  in  games,  on  the  contrary, 
no  two  plays  or  combination  of  plays  are  exactly  alike. 
One  can  never  tell  what  her  opponent  is  going  to  do,  and 


SYMMETRIC  DEVELOPMENT  351 

yet  what  one's  opponent  does  is  so  vital  to  the  success  or 
failure  of  the  game  that  the  player  must  decide  quickly 
and  accurately  how  that  move  in  the  game  can  best  be 
met,  so  that  intense  concentration,  quickness,  alertness, 
prolonged  attention,  self-control,  and  even  self-sacrifice 
are  called  for,  for  in  the  team  game  the  individual  inter- 
ests must  be  submerged,  in  order  that  the  side  may  win; 
and  so  the  individual  power,  sense  of  responsibility,  and 
an  esprit  de  corps  are  developed,  in  a  manner  almost  im- 
possible in  the  same  degree  in  any  other  way. 

The  principal  outdoor  games  for  women  are  croquet, 
lawn-tennis,  hockey,  golf,  hand-ball,  basket-ball,  baseball, 
boxing,  and  fencing. 

Croquet. — Of  all  these  games,  croquet  is  the  mildest, 
and  for  that  reason  is  a  good  beginning  game  for  a  woman 
who  has  always  led  a  sedentary  life,  or  for  a  woman  who 
has  become  enfeebled  through  serious  illness.  It  is  also 
an  excellent  game  for  old  age. 

To  be  beneficial  and  not  detrimental,  the  exercise  must 
be  very  gradually  increased,  both  in  the  length  of  time  oc- 
cupied and  in  the  vigor  of  the  movements.  The  muscles 
must  be  slowly  built  up  and  improved  in  tone,  the  lungs 
developed,  and  the  heart  strengthened. 

Another  advantage  of  croquet  is  that  it  is  inexpensive 
and  requires  a  limited  amount  of  ground. 

Lawn-tennis. — Tennis  is  a  much  more  violent  exercise 
than  croquet,  and  is  a  game  for  young  people  and  youth. 
Now,  as  to  just  what  constitutes  youth:  it  is  altogether  a 
question  of  the  condition  of  the  arteries,  heart,  and  mus- 
cular system,  and  is  not  a  question  of  years  per  se. 

The  game  is  moderately  expensive;  played  with  four, 
it  is  not  at  all  violent.  It  is  an  excellent  game  for  social 
purposes,  and  can  be  kept  up  until  late  in  life,  but  it  cannot 
be  begun  late  in  life.  It  has  just  the  proper  amount  of 
variety,  activity,  and  endurance  to  suit  hundreds  of 
people  for  whom  croquet  would  be  too  mild,  and  for  whom 
ball-games  would  be  too  severe. 

Golf. — Golf  is  deservedly  a  very  popular  game  at  all 


352  PERSONAL  HYGIENE   FOR  WOMEN 

ages.  Perhaps  the  greatest  drawback  for  the  city  dweller 
is  the  inaccessibility  of  the  golf  links  and  the  great  expense 
of  the  game. 

It  combines  scenery,  walking  for  several  miles,  some  hill 
climbing,  and  a  considerable  amount  of  exercise  for  the 
right  side  of  the  body,  particularly  for  the  right  arm,  and 
the  muscles  of  the  right  side  of  the  back  and  chest.  The 
great  drawback,  from  the  physical  standpoint,  is  an  over- 
development of  the  muscles  of  the  right  side  of  the  body, 
which,  in  the  majority  of  people,  are  already  better  devel- 
oped than  those  of  the  left  side ;  the  muscles  of  the  left  side 
of  the  body  are  brought  very  slightly  into  play. 

While  the  distinct  advantages  of  the  game  are  combined 
with  walking,  the  healthy  body  swings,  the  accuracy 
needed  in  making  the  drives,  the  distance  of  the  drives,  the 
variety  of  implements  as  well  as  of  stroke,  and  many  other 
features,  and,  further,  it  is  a  game  that  keeps  one  pleasantly 
employed  in  a  company  of  one's  choosing  for  several 
hours. 

Hockey. — Hockey  is  among  the  finest  of  games  for 
most  young  people,  and  should  rank  at  least  third  among 
games.  It  has  most  of  the  advantages  of  foot-ball,  and 
many  of  the  advantages  of  cricket.  It  involves  a  consider- 
able amount  of  running  and  a  great  deal  of  real  sport  and 
fun. 

Basket-ball. — This  is  another  of  the  most  popular 
games  for  young  people,  and  possesses  in  a  very  great 
degree  all  the  advantages  of  a  team  game.  The  confi- 
dence that  follows  a  successful  throw  proves  of  considerable 
value,  unless  it  leads  to  the  carelessness  of  overconfidence. 
Faith  in  the  ability  to  get  out  of  a  desperate  situation  in 
the  tossing  increases  with  success.  This  leaves  the  atten- 
tion imperturbed,  and  one  does  not  go  to  pieces.  Ac- 
cording to  Mosso,  movements  develop  the  brain,  and  it  has 
been  repeatedly  noticed  that  intelligence  in  animals  in- 
creases with  the  increased  motility  of  their  extremities. 


INDEX 


Abdomen,  protuberant,  328 
causes  of,  328 

treatment,  37,  46,  91,  286, 
328 
Abdominal  exercises,   328,   330, 
332 
muscles,  328 

development   of,   328,    330, 

332 
flabby,  135 
function  of,  134,  328 
Ablutions,  21-23 
cold,  22,  23 
hot,  22 
Acne,  61-65 
causes  of,  61 
treatment,  62-65 
Air,  amoimt  breathed  daily,  133 
"bouquet"  of,  137 
chemical  properties  of,  137 
country,  137 
degree  of  moisture  for  house, 

143,  144 
impurities  in,  causes  of,  140 
cmnulative   effects   of,    140, 

141 
injurious  effects  of,  141 
indoor,  139 
infection  of,  138 
overheated, injurious  effects  of, 

143 
pure,  test  of,  141 
23 


Air,  town,  137 

vitiation  of,  from  combustion 
of  Ughts,  140 
from  respiration,  140 
from  imhygienic  conditions, 
140 
Alcohol,  115-124 
absorption  of,  117 
anemia  from  use  of,  120 
as  a  food,  116,  117 
cumulative  effects  of,  116 
narcotic  effects  of,  116 
physiologic  action  of,  115-118 
obesity  caused  by,  120 
on  blood,  119 
on  brain  activity,  123 
on    digestion,    104,     105, 

118 
on  heart  and  blood-vessels, 

120,  121 
on  kidneys,  121 
on  hver,  118 
on  metabolism,  118 
on  muscular  system,  122 
on  nervous  system,    116, 

122,  123,  181 
on  oxidation,  interference 

with,  120 
on  self-control,  123 
rub,  directions  for,  23 
AlcohoUc  beverages,  amount  of 
alcohol  in,  116 

353 


354 


INDEX 


Alimentary    canal,    microorgan- 
isms of,  208 
Ambition,  excessive,  222,  232 
American        men,        improved 
physique  of,  275 
women,  inferior  physique  of, 
272 
Ammonia,   aromatic   spirits   of, 

dose  of,  206 
Anemia,  causes  of,  101,  141 
Anger,  injurious  effects  of,  233 
Anxiety,  injurious  effects  of,  234 
Arteries,  description  of,  127 
effect  of  cold  on  calibre  of,  18, 
128 
of  muscular  work  on  calibre 
of,  127 
Astigmatic  chart,  196 
Astigmatism,  correction  of,  196 
injurious  effects  of  imcorrected, 

196,  327 
test  for,  196 
Athletic  games  and  sports,  306- 
310,  349-352 
and    municipial    govern- 
ments, 306 
advantages  derived  from, 

306,  349-351 
basket-ball,  352 
benefits  of,  307-308 
best   suited    for    women, 

309,  310 
croquet,  352 

ethical  value  of,  306-309 
hockey,  352 
lawn-tennis,  351 
Attitude,  correct,  at  desk,  153 
in  standing,  324 
faulty,  injurious  effects  of,  152, 
326,  327 
Auto-infection,  109,  158 
Autosuggestion,  232 


Avocation,  186-188 
nature  of,  186 
physiologic  necessity  for,  188 

Back,  muscles  of,  289,  290 

exercises  for,  329,  331,  334, 

335 
function  of,  289,  290 
Bacteria,  action  of  sunlight  on, 
139 
role  played  by,  138 
Bacterial  flora,  147,  208 
Baldness,  causes  of,  71 
treatment  for,  71-74 
Basket-ball,  352 

Baths,  action  of,  in  health,  12,  54 
alkaUne,  26 
cold,  18-21 

contraindications  to,  19,  25 
heat  loss  in,  18 
physiologic  effects  of,  18 
reaction  after,  18,  19 
tonic  effect  of,  18,  20,  21 
training  for,  55,  56 
dip,  24 

contraindications  to,  25 
duration  of,  25 
temperature  of,  24 
effects  of,  12 
electric-light,  35-38 

directions  for,  35,  36,  38 
indications  for  its  use,  36, 37, 
210 
foot,  27,  28 

directions  for,  27 
indications  for,  28 
mustard,  171 
friction  after,  20 
hot,  17,  18 
effects  of,  17 
reaction  after,  17 
restorative  effects  of,  17,  18 


INDEX 


355 


Baths,  neutral,  effects  of,  17,  21 
temperature  of,  17 
proper  time  for,  55 
Roman,  35 
Russian,  34 

contraindications  for,  34 
indications  for,  34 
saline,  26 

as  cleansing  agent,  26 
salt  ablution,  32,  33 

indications  for  its  use,  33 
method  of  taking,  32,  33 
glow,  32 
shower,    or   rain   douche,   26, 
27 
cold,  27 

directions  for,  27 
effects  of,  27 
hot,  27 

indications  for,  27 
neutral,  27 
temperature  of,  27 
sitz,  28,  29 

duration  of,  29 
indications  for,  29 
temperature,  28 
sponge,  21-23 
tub,  23,  24 
fuU,  24 

contraindications  to,  24 
half,  23 

temperature  of  cold,  24 
of  hot,  23 
of  neutral,  24 
Turkish,  33-42 

contraindications  for  use  of, 

35 
essential  features  of  estab- 

hshment,  33 
indications  for  its  use,  35 
loss  of  weight  from,  37 
method  of  procedure,  33,  34 


Baths,    Turkish,    necessity    for 
cold  water  drinking,  34 
varieties  of,  21 
wet  hand  rubbing,  30-32 

class  of  cases  used  in,  31 
method    of    procedure, 

30,  31 
temperature  of  room,  31 
of  water,  31 
sheet,  29,  30 

indications  for,  30 
preliminary  procedures,  29 
technic  of,  30 
temperature  of  room,  29 
Bathtub  hose,  fallacy  in  use  of,  27 
Bedrooms,  ventilation  of,  144 
Beef  sandwiches,  directions  for 

making.  111 
Bile,  action  of,  89 
BiHous  attacks,  108,  109 
Biliousness,  108 
causes  of  1.08,  118 
symptoms  of,  108,  109 
treatment,  46,  109 
Bladder,  167 
capacity  of,  167 
frequency  of  emptying,  167 
location  of,  167 
Blood,  130 

corpuscles  of,  119,  130 
distribution  of,  130 
functions  of,  14,  119,  130 
length    of    time    for    passage 

through  body,  129 
thinness    of.     See    Anemia. 
vascular  areas  of,  15,  17 
Body,  balance  and  carriage  of, 
296,  310,  339 
common  defects  in,  297 
fatigue  of,  181 
position  of,  152,  153 
Boracic  acid,  solution  of,  202 


356 


INDEX 


Boxing,  337 

Brain  and  nervous  system,  172- 
176 

blood  supply  to,  during  sleep, 
181 

development  of,  177,  216-218, 
221,  229,  283,  308 

fatigue  of,  173 

effect  of  body  fatigue    on, 
182,  209,  304,  305 

functions  of,  172 

habit  and  automatism,  174 

master  organ  of  body,  172 

physiology  of,  175 

repair  of,  173,  174 

rest  of,  181,  185 

workers,  average  of  life  of,  221 
Brains  vigorous  and  strong  bod- 
ies, 278,  280 
Breathing,  art  of,  155 

difficult,  treatment  of,  155 

exercises.     See  Respiratory. 

normal,  154 

types  of,  155 
Bromid     mixtm-e,     prescription 

for,  206 
Bronchial  tubes,  131 
Bronchitis,  cause  of,  138 

chronic,  cure  of,  through  exer- 
cise, 156,  157 
Butter,  92,  94 
Buttermilk,  93 

Calomel,  dose  of,  109 
frequency  of  taking,  109 

Capillaries,  127 

Carriage,  good,  exercises  for,  329, 
333,  339 

Castor  oil,  administration  of,  110 

Cataract,  203 

Character,  formation  of,  219,  226, 
229 


Character  influenced  by  example, 
216,  226 
mental  poise,  222 
power  of  will,  230 
Chest,  description  of,  126 

development  of,  328,  340,  342 
exercises  for,  330,  333,  335, 

337,  338 
importance  of  good,  135 
flat,  causes  of,  153,  249,  253, 
297 
corrective  exercises  for,  153- 
156 
measurements  minimum  under 
arm,  consistent  with  good 
health,  135 
relation     between     height, 
weight,  and,  136 
weights,  exercises  with,  337- 
339 
for  arms,  338 
for  chest  expansion,  338 
for  shoulders,  338 
rules  for  taking,  337,  338 
Chilliness,  cause  of,  134 
Circulation,  maintenance  of  equi- 
libriiun,  131 
mechanics  of,  126-130 
Circulatory  apparatus,  127 

system,  125 
Clothing,  measurements  for,  152 
suspension  of,  from  shoulders, 
152,  270 
Clouston,  necessity  for   definite 

occupation,  236 
Club,  New  York  Colony,  316 
Clubs,  literary,  187 
model,  316 
women's,  316 

benefits  of,  187 
Young  Women's  Christian  As- 
sociation, 316 


INDEX 


357 


Clysters,  colo-,  49 

directions  for,  49,  50 
Cocoa,  95 

Coffee,  action  on  digestion,  105 
Cold,  effects  of  prolonged  appli- 
cation of,  18 
physiologic  effects  of,   18-21, 

127,  128 
reaction  following,  18,  19 
condition  unfavorable  to,  19 
how  promoted,  19,  20 
injurious    effects    following 
poor,  20 
tonic  effects  of,  20,  21 
Colds,  causes  of,  139,  141,  144, 
158 
common,  158 
contagiousness  of,  151 
frequency  of,  158 
reinfection  from,  158 
relation  of,  to  influenza,  157 
to  pneumonia,  157 
to  tuberculosis,  157 
treatment  of,  133,  158,  159 
prescription  for,  159 
quininin,  159 
College  life,  advantages  of,  220, 
221 
discipline  of,  221 
Vassar,  223 
woman's  medical,  223 
Coloclysters,  directions  for,   49, 

50 
Color  blindness,  203 
Complexion,  53,  54 
care  of,  58,  59 
good,  53,  54 
sallow,  60 
Conjunctivitis,  causes  of,  201 
granular.     See  Trachoma. 
symptoms  of,  202 
treatment  of,  202 


Conjunctivitis,     treatment     of, 
acute,  202 
chronic,  202 
Constipation,  112,  115 

and  mental  troubles,  113,  114 
causes  of,  106,  115,  328 
chronic,  112,  113 
injurious  effects  of,  98,  106, 
208 
appendicitis,  113 
autointoxication,  114 
hemorrhoids,  113 
uterine    displacements, 
114,  115 
symptoms  of,  106 
treatment,  46,  49,  50,  114,  115 
Corns,  treatment,  79 

varieties,  78 
Corsets,  243,  244-263 
abdominal,  257,  258 
crusade  against,  247 
curved  front,  249,  250 
directions  for  adjusting,  262 
effect  on  lung  capacity,  249, 
250 
on  muscles,  252-256 
on  thorax,  248 
history  of,  245-247 
hygienic,  257 
influence  on  female  body,  248- 

258 
injurious  effects  of,  248-257 
relation  to  abdominal  and  pel- 
vic disorders,  250-252 
straight  front,  256,  257 
tight  lacing  and,  248,  249,  262 
wearing  by  young  girls,  258- 

260 
what  style  is  least  injurious, 
260-262 
Cosmetics  for  the  face,  59,  60 
Cough,  fimction  of,  157 


358 


INDEX 


Country  folks,  outings  by,  188 
recreations  for,  187 

Crampton,  Dr.,  and  school  ath- 
letics, 275 

Croquet,  351 

Cures,  French,    of   the    Vosges, 
46-48 
Contrex^ville,  46-48 
Martigny'les-Bains,  46 
Vittel,  46,  47 

Dancing,  277,  314,  329 

aim  of,  339 

benefits  of,  339-341 

esthetic  and  classic,  339-341 

requisites  for,  339 

society,  339 
Dandruff,  69-71 

causes  of,  69 

contagiousness  of,  70 

treatment,  71-73 
Deafness,  causes  of,  151 

prevention  of,  151 
Debility   due    to    underfeeding, 
101,  102 

signs  of,  204 
Defecation,  98 
Desk,  correct  attitude  at,  153 
Development,  necessity  for  good, 
286,  299-302 

symmetric,  280,  303 
Diaphragm,  129,  130,  132,  249 

relative    importance    of,    132, 
135,  250 
Diarrhea,  acute,  diet  in,  112 
treatment,  112 

chronic,  112 
Diet,  deficient,  101-103 

finical,  90,  160 

importance  of  fats  in,  90,  91, 
94 
of  varied,  90 


Diet,  relation  of,  to  tuberculosis, 

90,  102,  160 
Dietary  in  health,  62 
in  indigestion,  110-112 
in  sedentary  occupations,  99- 
101 
breakfast,  99 
dinner,  99 
limcheon,  99 
objections  to  cereals  in,  99 
Digestion,  chemical  process,  84 
factors  which  favor,  96,  99 
gastric,  86-88 

length  of  time  required  for, 

87 
retarded  by  alcohol,  coffee, 
tea,  95 
habits  of,  90 
intestinal,  88 

maintenance  of  good,  80-101 
mastication  and,  86,  99 
nervous  system  and,  87,  97 
psychical  influence  on,  97 
Digestive  disorders,  103-113 
fluids,  89 

bile,  action  of,  89 
gastric  juice,  86 
intestinal  juice,  89 
pancreatic,  89 
saliva,  85 
system,  80 
tract,  80 
Discipline,  216,  217,  220 
Disinfectants,  carbolic  acid,  163 
formaldehyd,  162,  163 
sulphur,  162 
Disinfection   after    tuberculosis, 

directions  for,  162,  163 
Douche,  38-42 

after-treatment,  41 
application  of,  directions  for, 
39-41 


INDEX 


359 


Douche,  application  of,  mass,  38 
pressure,  38,  40 
temperature,  38,  40 
cold,  contraindications  to,  42 
long  applications,  41,  42 
mechanical  effects  of,  41 
physician's  prescription  for, 

42 
physiologic    effects    of,    41, 
42 
fan,  38 

horizontal  jet,  38 
neutral,  40 

indications  for,  42 
percussion,  38-41 

physiologic  effects  of,  39 
rain,  26,  27 

directions  for,  26,  27 
effects  of  pressure  in,  27 
rationale  of,  41 
relation  between  temperature, 

duration,  and  pressure,  41 
Scotch,  38 
temperature  of,  40 
and  its  effects,  41 
cold,  40 
hot,  40 

neutral,  40,  42 
time  for  taking,  41 
working,  40 
Dress    and    woman's     physical 
deterioration,  240-270 
corsets,  245-263 
gymnastic,  320 
history  of  woman's,  240-247 
French,  243-247 
Greek,  240-242 
mediaeval,  242-244 
renaissance,  244,  245 
Roman,  241,  242 
shoes,  263-265 
street,  winter,  270 


Drinks,  temperature  of,  96 
Drudgery,  joyless,  186 
Duodenum,  88 
effects  of  distention  of,  on  gas- 
tric digestion,  88,  89 
Dust,  its  relation  to  disease,  137 

Ear,  150 

ache,  treatment  of,  152 
description  of,  150 
douching,  52 
wax,  151 

removal  of,  151 
Eczema,  61 
chronic,  61 
seborrheic,  70 

causes  of,  71 

symptoms  of,  70 

treatment,  72,  73 
Education    and    the    health   of 

girls,  222 
coUege,  220 

discipUne,  220,  221,  308 
effect  on  home,  225 

on  physical  health,  222,  224 
higher,  of  women,  222-225 

President  EKot  on,  223-225 
mental  development,  216-220, 
308 

faculties,  balancing  of,  222 

habits,  174,  175 
moral  sense,  218,  219 
physical,  influence  on  health, 

298-304,  312 
religious  instincts,  219 
self-control,  217 
truthfuhiess,  216,  217 
Eggs,  digestibihty  of,  93,  100 

nutritive  value  of,  93 
Electric-Hght  baths,  35-38 

comparison  of,   with   other 
heating  procedures,  36 


360 


INDEX 


Electric-Kght  baths,  description 
of  cabinet,  35 
indications  for  use  of,  36,  37 
length  of  stay  in,  36 
reduction  of  weight  through, 

37 
symptoms  of  too  prolonged 

stay  in,  37,  38 
treatment,  finishing,  36 
Eliot,  President,  on  higher  edu- 
cation of  women,  223-225 
Emotional  nature,  218,  219 
Emotions,  depressing,  234 
physical  effects  of,  234 
the  natural,  214,  215,  218,  219 
violent,  231 
Employees,    care    of,    312,  313, 

341 
Enemas,  49,  60 

injurious  effect  of  daily,  50 
Envirormient,  225-228 
friends,  226 

harm  done  by  bad,  226,  227 
literature,  227,  228 
toilet,  225,  226 
Eustachian  tube,  150 
Exercise  after  eating,  304 
after  fasting,  319 
and  amusement,  341,  349,  350 
benefits  of,  299,  300,  301,  311- 

313 
effects  of,   on  brain   develop- 
ment, 279 
on  character,  279,  308 
on  heart  and  lungs,  283,  298 
on  muscles  and  blood-vessels, 
281,  282,  283,  300 
gradual  training  in,  300 
heart's  need  of,  298 
increase    of    red    blood    cells 

through,  282 
length  of  time  for,  318,  342 


Exercise,  outdoor,  horseback  rid- 
ing, 316,  348 

mountain  climbing,  345 

rowing,  348,  349 

running,  325,  344 

swimming,  345-348 

walking,  342-344 
passive.    See  Massage. 
physiology  and  pathology  of, 

280,  299,  300 
regularity  in,  276,  319,  342 
rules  for  taking,  318-320 
Exercises,  corrective,  for  develop- 
ing various  regions  of  the 
body,  325-339 

abdominal,  330, 332, 335, 336 

alternate  kneeling,  332 

arms,  329,  335,  337,  338 

balancing,  333 

back,  for  muscles  of,  331, 
334,  335,  336 

carriage,  333 

chest,  335,  336,  337,  338 
for  extending  depth  of,  333 
forward  projection  of,  330 

hips,  336 

legs,  331,  335,  336 

poise,  333 

respiratory,  330 

rope-pulling,  335,  336 

shoulder-blade,  329,  330,  331 

spine,  332 

squatting,  332 

standing,    correct    attitude 
in,  324 

swimming,  335 

thighs,  335 

trimk  flexions,  336,  337 
lateral,  334,  336 

waist,  334,  335 
exhaustion,  recovery  from,  281; 

282 


INDEX 


361 


Exercises,  free,  rules  for  taking, 
327 
of  endurance,  280,  281,  283 
of  strength  and  skill,  280, 
281,  283 
Exhaustion,  injurious  results  of, 
181,  182,  185,  209 
recovery  from,  282 
symptoms  of,  182-184 
Eyes,  192-199 
care  of,  200 
healthy,  197 
injuries  to,  201 
interruption  of  work  of,  197, 

198 
protection  of,  199 
removal  of  foreign  bodies  from, 
201.     See  Vistud  apparatus. 
Eyestrain,  192 
general  symptoms  of,  197 
local   symptoms  of,  197 
mechanism  of,  197 
prevention  of,  198 

Face  as  index  of  health,  53 
cleansing  of,  58 
dryness  of  skin  of,  58 
lotions,  59 
massage  of,  64 

with  cupping  glass,  64 
powders,  59,  60 
protection  of,  59 
steaming,  63 
use  of  cosmetics,  59 

of  soap,  58 
Facial  blemishes,  61-67 
eczema,  61 

causes  of,  61 

general  treatment,  62,  63 
freckles,  60,  65 
liver  spots,  60,  65 
pimples  and  acne,  61 


Facial  pimples,  causes  of,  61 
prescriptions  for,  65 
treatment  of,  62-65 
sallow  complexion,  60 
treatment,  62,  63 
superfluous  hairs,  removal  of, 

66 
wrinkles,  66-68 
Far-sightedness,  195 
Fatigue,  imdue,  282 
causes  of,  187,  291,  292 
danger  signal,  181 
economic  waste  of,  182 
effect  of  brain,  on  body  fatigue, 

304,  305 
effect  of,  on  nerve  cells,  180 
mental  symptoms  of,  180 
muscular,  291,  292 
normal,  180 
recovery  from,  282 
toxins  of,  178-180,  191 
treatment,  210,  293 
Fear,  215 
forms  of,  215 

physical  effects  of,  215,  232 
universality  of,  215 
Feet,  care  of,  78,  79 
corns,  treatment  of,  74 
ingrowing  nails,  78 
perspiration  of,  65,  78 
protection  of,  264,  265 
Female  form,  relative  proportion 
of,  284 
generative  organs,  167 
Fallopian  tubes,  167 
function  of,  167 
ovaries,  167 
physiology  of,  167 
uterus,  168 
functions  of,  168 
respiratory  movements 
of,  168 


362 


INDEX 


Fencing,  337 

Food,  amount  required  in  twenty- 
four  hours,  92 
at  too  frequent  intervals,  96, 

104 
digestibility  of,  104 
beef,  93 
buttermilk,  93 
chicken,  93 
eggs,  93 
koumiss,  93 
milk,  93 
mutton,  93 
pork,  93 
excessive  quantity,  98,  103 
indigestibiUty  of,  104 
preparation  of,  62,  63 
temperature  of,  96 
Food-stuffs,  classification  of,  91 
carbohydrates,  92 
starches,  92 
sugars,  92,  94,  112 
fats,  92 

butter,  94 
proteids,  91 

as  source  of  energy,  91 
daily  amoimt  required,  62, 

92,  102 
injurious  effects  of  excess 
of,  92 
salt,  94 
water,  97 
Foot,  configuration  of,  321,  322 
description  of,  in  walking,  322- 
324 
Freckles,  60 

treatment  of,  65 
French  cures  of  the  Vosges,  46-48 
rules  for  taking  waters,  47, 48 
dressing  for  salad,  101 

injurious  effects  of  vinegar 
in,  94,  95 


Friction,  mechanical  effects  of, 

20,  294 
Friends,  choice  of,  226 

molding  effects  of,  226,  227 

requirements  for,  227 

Gaches-Sarraute,  Madame,  hy- 
gienic corsets,  257 
Games  as  supplement  to   gym- 
nastics.    See    Athletic    games 
and  sports. 
Golf,  351,  352 
Greek  costumes,  240-242 
Gymnasixmi  in  campaign  against 
disease,  311-313 
Vassar  College,  313-316 
Gymnasiiuns,  320,  321 

against  disease,  300,  301,  311- 

313 
and  factories,  312,  313,  341 
and  women's  clubs,  316 

colleges,  313 
Yoimg  Women's  Christian  As- 
sociation, 316 
Gymnastic  dress,  320 
Gymnastics,  benefits  from,  302- 
304 
for    symmetric    development, 

303 
medical,  302 
physical  examination  for,  314, 

315 
practice  of,  302 
versus  athletics,  301 

Habit  and  automatism,  174 
Habits  and  disease,  232 

age  hmit  for,  174,  175 

bad,  174 
Hair,  69-75 

brushing,  72 

care  of,  71-73 


INDEX 


363 


Hair,  cutting  of,  74 
dandruff,  69 
description  of,  69,  70 
dressing,  74 
gray,  74 
causes  of,  74 
treatment  of,  75 
premature  thinness  of,  69 
treatment  of,  71,  72 
scalp,  dry,  treatment  of,  73,  74 
massage  of,  73 
oily,  prescriptions  for,  73 
seborrheic  eczema,  70 
shampoo,  72 
treatment  of,  72 
Hair-brush,  72,  73 

care  of,  73 
Hairs,  superfluous,  66 

treatment  by  electrolysis,  66 
by  lotions,  66 
Hancock,  Dr.,  physical  training 

for  women,  274 
Hands,  care  of,  75-77 
chapped,  76 
nails,  care  of,  76 
cleansing  of,  77 
infection  from  lack  of  clean- 
liness, 76 
Headache,  204-207 

causes  of,  197,  204,  205,  209 
symptoms  of,  205 
treatment  of,  205-207 
varieties  of,  205 
neuralgic,  205 
Health,  good,  and  vacations,  189, 
190 
evidences  of,  203 
Hearing,  impairment  of,  causes 

of,  151 
Heart,  description  of,  127 
failure    due   to   underfeeding, 
101-103 


Heart,  frequency  of  beat,  128 

functions  of,  127 

location  of,  127 
Heart's  need  of  exercise,  298 
Heat,  animal,  14-16 

dissipation  of,  15 

physiologic  effects  of,  15,  16 

production  of,  14,  15,  291,  296 
Height,  weight,  and  chest  meas- 
urements, relative  proportion 

of,  136,  285 
Hemorrhoids,  113 
Hereditary  predispositions,  213 
Heredity,  influence  of,  on  health, 

212-214 
Hockey,  352 
Horseback  riding,  316 
Hot-water  bottle,  action  of,  18 
Houses,  degree  of  moisture  of  air 
of,  143 

disinfection  of,  after  tubercu- 
losis, 162,  163 

effects  of  gloomy,  226 

temperature  of,  143 

ventilation  of,  139-143 
Hydrotherapy  defined,  11 

value  of,  11.     See  Baths  and 
douches. 
Hygiene  of  mind,  212-239 
Hygrometer,  144 
Hyperidrosis,  treatment  of,  65 

Idleness    as    cause  of  nervous 
prostration,  211,  235 

Thomas  on  ill  effects  of,  236, 
237 
Indigestion,  103-108 

causes  of,  103-106,  118 

diet  in,  110-112 

intestinal,  107 

symptoms  of,  108,  109 
treatment  of,  36,  45,  109 


364 


INDEX 


Indigestion,  nature  of,  105 

symptoms  of,  106-108 
Industrial    training    of    women, 

necessity  for,  235 
Infectious  diseases,  157-163 

bronchitis,  147, 148, 156, 157 
causes  of,  137-139,  141,  147 
common  colds,  147,  157-159 
influenza,  147,  157,  158 
pharyngitis,  139,  147,  148 
Influenza,  157 
cause  of,  138,  147 
relation  of,  to  pneumonia,  159 
to  tuberculosis,  157,  161 
Ingrowing  toe-nails,  causes  of,  78 

treatment  of,  78 
Inhibition,  228-230 
importance  of,  230 
training  in,  229 
Insomnia,  184 

causes  of,  182,  184,  208 
injurious  effects  of,  191,  207 
treatment  of,  27,  192 
Intestinal  catarrh,  112 
treatment  of,  110 
Irrigations,  vaginal,  50-52 

Kidneys,  description  of,  163 
diseases  of,  treatment  of,  45 
function  of,  163-167 

relation  of,  to  skin  and  lungs, 
164 
Knee-chest  position,  description 
of,  49 

Lamp  shades,  199,  200 

Larynx,  131 

Laughter,   physiologic  necessity 

for,  188,  189 
Life,  prolongation  of,  121,  301 
Lighting,  artificial,  199,  200 

natural,  200 


Literature,  227,  228 
molding     influence     on     the 

mind,  227 
taste  for,  formed  in  youth,  228 
Lungs,  131 

description  of,  131 
frequency  of  diseases  of,  125 
good  development  of,  125,  299 
exercises  for,  153-156, 330, 
333,  337 
hygiene  of,  clothes  in  relation 

to,  152 
relation  of,  to  good  health,  134 
secretion  of,  133 
ventilation  of,  153-156 
vital  capacity  of,  136 
weakness  of,  causes  of,  125 

Massage  defined,  292 
benefits  of,  292-294 
mode  of  procedure,  295 
movements  of,  294 
friction,  294 

grasping  and  pinching,  294 
striking,  295 
stroking,  295 
vibration,  295 
rise  of  temperature  after,  296 
time  for  giving,  295 
Mastication,  82,  85,  99 

imperfect,  103 
Meals,  arrangement  of,  96 
Meats,  fresh,  digestibility  of,  93 
nutritive  properties  of,  92 
roast,  how  to  prepare,  92 
Menstruation,  169-171 
anomalies  of,  171 
painful,  171 
profuse,  171 
scanty,  171 
suppressed,  171 

treatment  of,  170,  171 


INDEX 


365 


Menstruation,  hygiene  of,  169 
normal,  average   duration  of, 
169 
character  of,  169 
cold  baths  during,  169,  170 
exercise  during,  170 
premonitory  symptoms  of,  169 
Mental    activity,    attitude    and 
bodily  fimction  of,  230 
depression,  219 

development,   177,   178,   216- 
220,  221,  229 
and  physical  training,  278- 
280,  283,  303,  308 
disorders  of  adolescence,  219 
emotions,  exhausting  nature  of, 

233-235 
faculties,  balance  of,  222 
habits,  174,  175 
hygiene,  212-235 

hurry,  effect  of,  178 
quahties,  216 
Metabohsm,    cmnulative    effects 

of  impure  air  on,  141 
Microorganisms     in    alimentary 
canal,  90 
growth  inhibited  in  health,  90 
in  imcooked  food,  90 
Migraine,  treatment  of,  206 
Milk,  digestion  of,  93 
Mind    hygiene,    relation    of,    to 
physical  health,  212-239, 308 
subconscious,  226 
Mineral  waters,  Contrex^ville,  47, 
48 
Vichy,  111 
Vittel,  45,  47 
Moral  sense,  218,  219 
Mothers  as  educators,  212 

exhausted,  185 
Mountain  cHmbing,  345 
Mouth,  care  of,  82 


Mouth,  cleansing  of,  82 
Muscular  system,  286-292 

action  of  muscles  of  abdo- 
men, 288 
of  back,  289 
coordination,  292 
development  prevented  by  cor- 
sets, 248,  249,  252-256,  258, 
259 
energy,  291 
fatigue,  291 
heat  production,  291 

Nasal  catarrh,  causes  of,  147 
general  treatment,  149 
local,  148,  149 
prevention  of,  148 
douche,  149 

passages,  obstruction  of,  146 
sprays,  148 

prescriptions  for,  149 
Nature's  restoratives,  184-188 
recreation,  186,  188 
rest,  185 

sleep,  186,  190,  191 
Near-sightedness,  causes  of,  194, 
195 
correction  of,  195 
Nervous  breakdowns,  prevention 
of,  185,  187,  189 
disorders,  causes  of,  204 
functional,  203,  211 
headache,  204-207 
neurasthenia,  207 
system  as  balance  of  power, 
172 
brain   as  master   organ   of 
body,  172 
function  of,  172 
physiology  of ,  175 
cerebrospinal  nerves,  175 
spinal  cord,  175 


366 


INDEX 


Nervous    system,    sympathetic, 

176 
Nervousness,  184 

causes  of,  184 

treatment  of,  293 
Neurasthenia,  207-211 

causes  of,  207,  208 

rational  treatment  of,  30-32, 
209-211,  293 

symptoms  of,  209 
New  York  Colony  Club,  316 
Nose,  care  of,  145 

fimctions  of,  145 

Obesity,  causes  of,  120,  286 
treatment  of,  37,  46,  91,  286, 
328 
Occupation,  definite,  a  physical 
necessity,  235 
Clouston  on,  236.     See  Voca- 
tion. 
sedentary,  153 
Optical  defects  and  their  correc- 
tion, 194-197 
astigmatism,  196 
hyperopia  or  far-sightedness, 

195 
myopia  or  near-sightedness, 
194 
causes  of,  195,  197 
treatment  of,  195 
presbyopia   or   loss    of    ac- 
commodation, 195 
Out-door  exercise,  342 

daily  length  of  time  for,  342 
Overeating,  98 

experiments  of  Prof.  Chitten- 
den, 98,  99 
factors  leading  to,  99 
iU-effects  of,  99 
Overwork,  181,  182 
danger  signals,  181 


Overwork,  signs  of,  182-184 

stimulants  in,  181 

worry  and,  183 
Overworked  class,  rest  treatment 

for,  210,  211 
Oxygen,  importance  of,  133 

Palate,  soft,  146 
Pancreatic  juice,  89 

action  of,  on  food-stuffs,  89 
Perspiration,  daily  amount  of,  14 
effect  of,  on  tone  of  skin,  17 
rate  of  increase  in  hot  baths,  17 
Pharynx.     See   Throat. 
Physical  efficiency,  marks  for,  305 
examination,  317,  318 
exercise,  rules  for,  318-320 
measurements,  record  for,  315, 

318 
training  key    to    health   and 
beauty,  271-310 
among  the  ancients,  271, 272, 

277 
before  twelve  years  of  age, 

317 
dancing,  277,  314,  329 
examinations  for,  314,  315 
for  invaUds,  317 
improved     physique     from, 

274,  313 
influence  on  life  and  health, 

278 
of  girls,  276,  277,  309,  317 
of  Japanese  women,  274 
report  of  Royal  Commission, 
on,  276 
Physique,  good,  through  physical 
training,  316,  317 
improved,  of  American  women, 
275 
of  school  children,  275 
Play,  adult,  276 


INDEX 


367 


Pleasure  seeking   as   the  object 

of  life,  177,  235,  237 
Pneumonia  following   influenza, 
157 
mortality  from,  159 
Proteids  as  source  of  energy,  91 
daily  amount  required  to  pro- 
tect organism  against  body 
loss,  102 
injurious  results  of  excess  of,  99 
Ptomain  poisoning,  109,  110 

treatment  of,  110 
PuUey  weights,   exercises  with. 

See  Chest  weights. 
Pulse,  frequency  of,  128 

Reading,  distance  of  book  from 
eyes,  153 
fine  type,  200 

hygienic  precautions,  200,  201 
length  of  line,  200 
position  of  reader  in,  200 
Recreation,  necessity  for,  208 
ReUgion,  220 

Religious  instincts,  219,  220 
Respiration  during  sleep,  154 
forced,  benefits  of,  153,  154 
impediments  to  normal,  152 
mechanics  of,  126,  129 
normal,  relation  to  body  heat, 

134 
types  of,  155 
costal,  155 
diaphragmatic,  155 
thoracic,  155 
vitiation  of  air  in,  140 
Respiratory  exercises,   153-156, 
330 
beneficial  results  of,  299 
best  time  for,  154,  155 
dress  for,  154 
frequency  of,  practice  of,  154 


Respiratory  system,  125-145 
air  cells,  131 
bronchial  tubes,  132 
expiration,  131 
inspiration,  131 
forced,  132 

function     of     abdominal 
muscles,  134,  328 
larynx,  131 
lungs,  131 

hygiene  of,  and  relation  to 

general  health,  134 
secretion  of,  133 
vital  capacity  of,  132 
thorax,  126 
trachea,  131 
Rest,  185 

days  of,  188,  189 
proper  way  to,  185,  186 
regularity  of,  185 
Roman  baths,  35 
Rowing,  348,  349 
Runmng,  281,  344,  345 
age  hmit  for,  344 
benefits  of,  298 
rules  for,  325 

Saliva,  82 

fimction  of,  85,  86 
Salt,  common,  94 

normal,  solution,  49 

sea,  32,  33 
Sargent,  Dr.  Dudley  A.,  272,  273, 

275,  305,  309 
Scalp,  massage  of,  73 
Sebaceous  glands,  function  of,  13 

infection  through,  13 
Self-control,  217,  218 

difficulty  of,  217 

standards  aimed  at,  217 

training  in,  218 
Senihty,  causes  of,  121 


368 


INDEX 


Sewing,  hygienic  precautions  in, 

200,  201 
Shoe,  263-265 

compression  of  foot  by,  263 
flat  heels,  264 
French  heels,  265 

awkward  gait  due  to,  265, 

323 
deformities  caused  by,  265 
injurious  effects  of,  265 
proper  length  of,  264 
soles  of,  264 
Shoulder-blade     exercises,    329, 

330 
Shoulders,  round,  and  inequality 
of  height  of,  326 
causes  of,  326 

corrective  exercises  for,  329, 
330 
Sims' position  described,  49 
Skin,  absorption  through,  16 
care  of,  53-68 
description  of,  12-14 
diseases,  acne,  61 
eczema,  61 
treatment  of,  62-65 
functions  of,  14-16 
respiration  through,  16 
role  played  in  maintaining 
body  temperature,  14-16 
sebaceous  glands,  13 
sweat  glands,  13 

perspiration,  daily  amount 
of,  14 
temperature  of,  19 
tone  of,  13 
Skirt,  walking,  190-192 
Sleep,  190-192 
amoimt  necessary,  184,  191 
dreamless,  192 

favorable   conditions  for,  192 
habits  of,  186,  191 


Sleep,  physiologic  necessity  for, 

173, 180,  181,  191 
Sleepiness,  causes  of,  191 
Soap,  54 
castile,  57 
sand,  57 

tincture  of  green,  72 
Social  instincts,  214 
at  school  age,  214 
right  training  of,  229 
Sore  throat,  prevention  of,  148 

treatment  of,  148,  149 
Spinal  cord  center  of  reflex  acts, 
175 
curvature;,  297 

causes  of,  152,  326,  327 
general  treatment  for,  327 
Spine,  muscles  of,  exercises  for 

strengthening,  332,  333 
Spirometer,  136 
Sponge  as  article  of  toilet,  21 
Spray  apparatus,  description  of, 
148 
hqmds  for,  149 
oil,  formula  for,  149 
Standing,  common  defects  in,  324 

correct  attitude  in,  324 
Stocking  supporters,  266 
Stockings,  evils  of  short,  265 
Stomach,  capacity  of,  98 
description  of,  86 
location  of,  86 
work  done  in,  87 
Street  dress,  winter,  270 
Styes,  treatment  of,  203 
Success  defined,  237 
elements  of,  237 
lack  of,  238 

mental  condition  and,  238 
psychology  of,  237-239 
Sugar,  injurious  effects  of  excess 
of,  94 


INDEX 


369 


Sunlight,  action  on  respiration, 
137 
on  tubercle  bacillus,  139 
Swimming,  345-348 

contraindications  to,  348 
exercises,  335 
pool,  temperature  of,  314 
rules  for,  346,  347 
Swift,  Prof.,  theories  regarding 
children,  216,  217 
fighting    among    boys, 
217 

Tea,  effect  of,  on  digestion,  95, 
105 
proper  way  to  make,  95 
Teeth,  82 

care  of,  82,  83 
cleansing  of,  83 
defective,  103 
septic,  103 
tartar,  83 
tooth-brush,  83 
Temperament,  213,  214 
arthritic,  214 
nervous,  213 

temptations  of,  214 
phlegmatic,  214 
Temperature  for  house,  143 
normal  body,  16 
axilla,  16 

how  maintained,  16 
mouth,  16 
rectum,  16 
surface,  19 
Thomas,  Prof.,  on  effect  of  idle- 
ness, 236 
on  necessity  of  definite  vo- 
cation, 237 
Throat  or  pharynx,  125 
bacterial  flora  in,  139 
description  of,  146 
24 


Throat,   diseases   of,    causes  of, 
146 
effect  of  lowered  vitaUty  on, 

139 
importance  of  healthy  condi- 
tion of,  139,  147 
pillars  of,  146 
sore,  prevention  of,  148 
treatment  of,  148,  149 
Toe-nails,  ingrowing,  78 
Tonsils,  chronic  enlargement  of, 

147 
Trachea,  131 
Trachoma,  202,  203 
Tubercle  bacillus,  138 

destruction  of,  162 
Tuberculosis,  causes  of,  125,  138, 
297 
diet  in,  102,  160 
disinfection  after,  162,  163 
due  to  underfeeding,  102 
expectoration  in,  138,  161 
infection  in,  138,  161 

source  of,  161 
mortahty  in,  125 
prevention  of,  102, 159-162 
Turkish  baths,  33-35 
cold  plunge,  34 

contraindications       to, 
19,25 
contraindications    for  their 

use,  35 
essential  features  of  estab- 
lishment, 33 
harmful  results  of  too  pro- 
longed stay  in,  34 
indications  for  their  use,  35 
methods  of  procedure,  33-35 
necessity    for     cold    water 

drinking,  34 
physician's  prescription  for, 
35 


370 


INDEX 


Turkish  baths,  shampoo,  34 
steam  room,  34 

contraindications       for 
use  of,  34 

Underclothing,      combination 
suits,  268 

winter,  266-269 

equestrian  tights,  268 
essential  qualities  of,  266 
Underfeeding,  chronic,  101 

dyspepsia  as  result  of,  101,  102 

heart  failure,  101 

mental  depression,  102 

tuberculosis,  102 
Uric  acid,  treatment  of,  36 
Urinary  excretory  apparatus,  167 
Urine,  166 

daily  amount  of,  166 

secretion  of,  164 

specific  gravity  of,  166 

toxicity  of,  166,  167 

urea,  166 

uric  acid,  166 

value  of  study  of,  166 
Uvula,  relaxation  of,  146 

Vacations  and  health,  189,  190 
resorts,  requisites  for,  190 
rules  for,  190 
Vaginal  irrigations,  50-52 
directions  for,  50,  51 
indications  for  use  of,  51 
Vassar  College,  223 

gymnasium,  313-316 
Veils,  198 

Ventilation,  139-143 
method  of,  142 
necessity  for  indoor,  139 

hourly  amount  of  fresh  air 
needed,  139 
of  bed-clothes,  145 


Ventilation  of  bed-rooms,  144 
of  houses,  139-143 
of  lungs,  153-156 
Vinegar,  94 
Vision,    defective.     See    Optical 

dejects. 
Visual  apparatus,  193,  194 

accommodation,  mechanism 

of,  194 
conjxmctiva,  193 
description  of,  193 
eyeball,  193 
eyelashes,  193 
eyelids,  193 

image,  formation  of,  194 
iris,  193 

function  of,  194 
lachrymal  glands,  193 
tears,  function  of,  193 
Vocation,   physiologic   necessity 
for,  235 
Clouston  on,  236 
Thomas  on,  236,  237 

Waist  exercises,  334,  335,  340 
Walk,  listless,  bad  effects  of,  343 
Walking,  clothing  for,  270,  343 
effect  of  speed  in,  281 

on  blood-vessels   and   mus- 
cles, 343 
on  heart  and  lungs,  342,  343 
position  of  feet  in,  325 
skirt,  269 

proper  length  of,  269 
Walks,  rules  for  long,  343 
Warts,  treatment  of,  77 
Wash  cloths,  care  of,  57 

danger  of  infection  from,  57 
Water,  internal  use  of,  42-46 
action  on  digestion,  44 

on  heart  and  blood,  43 
at  meals,  44 


INDEX 


371 


Water,    internal  use  of,  boiled, 
43 
classification  of  tempera- 
ture of,  16 
cold,  contraindications  to, 

46 
infection,  vehicle  for,  43 
mineral,  98 

physiologic  effects  of,  16 
therapeutic       indications 

for,  44-46 
time  required  for  its  ab- 
sorption 44 
Weichardt,  Dr.,  experiments    on 

guinea-pigs,  179 
Weights    for    women,   table    of, 
relation  between  height   and, 
284,  285 
Weisse,  Dr.,  table  of  weights,  etc., 

284,  285 
Will,  education  of,  229-233 
influence  of,  on  conduct,  229, 

230 
inhibition,  228-230 
obsessions,  overcoming,  of,  229 
power  of,  and  strong  muscles, 
279,  280 


Will,  training  of,  229 
Women,  American,  cause  of  in- 
ferior physique  of,  272-274 

average  height  of,  286 

higher  education  of,  222-225 

in  business  activities,  225,  236 

Japanese,  274 

non-occupation  of,  236,  237 

noted  sovereigns  as  mothers, 
235 
Women's  clubs,  316 
Woolen  undergarments,  267,  268 
Work,  hygiene  of,  176 

number  of   hours  allotted  to, 
182 

philosophy  of,  176 

physiologic  necessity  for,   177 
Worry,  183,  184 

defined,  233 

results  of,  234 
Wrinkles,  66-68 

causes  of,  66,  67 

results  of,  67,  68 
Writing,  use  of  typewriter,  153 

Young  Women's  Christian  Asso- 
ciation, 316 


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and  how  it  should  be  run,  from  the  scrubwoman  up  to  its 
financing." 

Hospital  Management.  Arranged  and  edited  by  Charlotte  A. 
AIKENS,  formerly  Director  o^  Sibley  Memorial  Hospital,  Washing- 
ton, D.  C.      i2mo  of  488  pages,  illustrated.  Cloth,  $3.00  net 

Aikens'  Primary  Studies         new  (2d)  edition 

Trai7ied  Nurse  and  Hospital  Review  sa^^s:  "It  is  safe  to  say 
that  any  pupil  who  has  mastered  even  the  major  portion  of 
this  work  would  be  one  of  the  best  prepared  first  year  pupils 
who  ever  stood  for  examination." 

Primary  Studies  for  Nurses,  By  Charlotte  A.  Aikens,  formerly 
Director  of  Sibley  Memorial  Hospital,  Washington,  D.  C.  i2mo  of 
437  pages,  illustrated.  Cloth,  $1.75  net. 

Aikens'  Training-School  Methods  and 
the  Head  Nurse 

This  work  not  only  tells  how  to  teach,  but  also  what  should 
be  taught  the  nurse  and  how  much.  The  Medical  Record  says: 
"  This  book  is  original,  breezy  and  healthy." 

Hospital  Training-School  Methods  and  the  Head  Nurse.  By  CHAR- 
LOTTE A.  Aikens,  formerly  Director  of  Sibley  Memorial  Hospital, 
Washington,  D.  C.    i2mo  of  267  pages.  Cloth,  $1.50  net 

Aikens'    Clinical    Studies       new  (2d)  edition 

This  work  for  second  and  third  year  students  is  written  on  the 
same  lines  as  the  author's  successful  work  for  primary  stu- 
dents. Dietetic  and  Hygienic  Gazette  says  there  "  is  a  large 
amount  of  practical  information  in  this  book." 

Clinical  Studies  for  Nurses.  By  CHARLOTTE  A.  Aikens,  formerly 
Director  of  Sibley  Memorial  Hospital,  Washington,  D.  C.  lamo  of 
56g  pages,  illustrated  Cloth,  $2.00  net 


Bolduan  and  Grund's  Bacteriology   ready 

The  authors  have  laid  particular  emphasis  on  the  immediate 
application  of  bacteriology  to  the  art  of  nursing.  It  is  an 
applied  bacteriology  in  the  truest  sense.  A  stud}^  of  all  the 
ordinary  modes  of  transmission  of  infection  are  included. 

Applied  Bacteriology  for  Nurses.  By  Charles  F.  Bolduan,  M.  D., 
Assistant  to  the  General  Medical  Officer,  and  Marie  Grund,  M.D., 
Bacteriologist,  Research  Laboratory,  Department  of  Health,  City  of 
New  York.     i2mo  of  i66  pages,   illustrated.  Cloth,  $1.25  net. 


Fiske's  The  Body 


A  NEW  IDEA 


Trained  Nzirse  and  Hospital  Review  says  "it  is  concise,  well- 
written  and  well  illustrated,  and  should  meet  with  favor  in 
schools  for  nurses  and  with  the  graduate  nurse." 

Structure  and   Functions  of  the   Body.     By  Annette  Fiske,  A.  M., 

Graduate  of  the  Waltham  Training  School  for  Nurses,  Massa- 
chusetts.    i2mo  of  221  pages,  illustrated.  Cloth,  $1.25  net 

Beck's  Reference  Handbook  new  (3dTL''i?toN 

This  book  contains  all  the  information  that  a  nurse  requires 
to  carry  out  any  directions  given  by  the  physician.  The 
Montreal  Medical  Journal  S2iy^  it  is  "cleverly  systematized  and 
shows  close  observation  of  the  sickroom  and  hospital  regime." 

A  Reference  Handbook  for  Nurses.  By  AMANDA  K.  Beck,  Grad- 
uate of  the  Illinois  Training  School  for  Nurses,  Chicago,  111, 
32mo    volume    of   244    pages.     Bound    in  flexible  leather,    $1.25  net. 


JUST 
READY 


Roberts'  Bacteriology  &  Pathology 

This  new  work  is  practical  in  the  strictest  sense.  Written 
specially  for  nurses,  it  confines  itself  to  information  that  the 
nurse  should  know.  All  unes.sential  matter  is  excluded.  The 
style  is  concise  and  to  the  point,  yet  clear  and  plain.  The  text 
is  illustrated  throughout.    " 

Bacteriology  and  Pathofogy  for  Nurses.     By  Jay  G   ROBERTS,  Ph.  G., 
M.  D.,  Oskaloosa,  Iowa.      lomo  of  206  pages,  illustrated.       $1.25  net. 


DeLee's  Obstetrics  for  Nurses      editioS 

Dr.  DeLee's  book  really  considers  two  subjects — obstetrics 
for  nurses  and  actual  obstetric  nursing.  Trained  Nurse  atid 
Hospital  Review  says  the  "book  abounds  with  practical 
suggestions,  and  they  are  given  with  such  clearness  that 
they  cannot  fail  to  leave  their  impress." 

Obstetrics  for  Nurses.  By  Joseph  B.  DeLee,  M.  D.,  Professor  of 
Obstetrics  at  the  Northwestern  University  Medical  School,  Chicago. 
i2mo  volume  of  512  pages,  fully  illustrated.  Cloth,  $2.50  net. 

Davis'  Obstetric  &  Gynecologic  Nursing 

JUST  READY— NEW   (4th)   EDITION 

The  Trained  Nurse  and  Hospital  Review  sa5^s:  "  This  is  one 
of  the  most  practical  and  useful  books  ever  presented  to  the 
nursing   profession."     The  text  is  illustrated. 

Obstetric  and  Gynecologic  Nursing.  By  Edward  P.  Davis,  M.  D., 
Professor  of  Obstetrics  in  the  Jefferson  Medical  College,  Philadel- 
phia,    ivimo  volume  of  480  pages,  illustrated.  Buckram,  $1.75  net. 

Macfarlane's  Gynecology  for  Nurses 

ILLUSTRATED 

Dr.  A.  M.  Seabrook,  Woman's  Hospital  of  Philadelphia,  says: 
"It  is  a  most  admirable  little  book,  covering  in  a  concise  but 
attractive  way  the  subject  from  the  nurse's  standpoint.  You 
certainly  keep  up  to  date  in  all  these  matters,  and  are  to  be 
complimented  upon  your  progress  and  enterprise." 

A  Reference  Handbook  of  Gynecology  for  Nurses.  By  Catharine 
Macfarlane,  M.  D.,  Gynecologist  to  the  Woman's  Hospital  of  Phil- 
adelphia. 32mo  of  150" pages,  with  70  illustrations.  Flexible  leather, 
$1.25  net. 


McKenzie's  Exercise  in   Education  and  Medicine 

Exercise  in  Education  and  Medicine.  By  R.  Tait 
McKenzie,  B.A.,  M.D.,  Professor  of  Physical  Educa- 
tion, and  Director  of  the  Department,  University  of 
Pennsylvania.  Octavo  of  406  pages,  with  346  illustra- 
tions. Cloth,  13.50  net. 


Manhattan  Hospital  Eye,  Ear,  Nose, 
and  Throat  Nursing  illustrated 

This  is  a  practical  book,  prepared  by  surgeons  who  know  the 
nurse's  requirements  in  these  specialties.  New  York  Medical 
Record  SB-xs:  "  Every  side  of  the  question  has  been  fully  taken 
into  consideration." 

Nursing  in    Diseases   of  the   Eye,    Ear,   Nose     and    Throat.       By  the 

Committee  on  Nurses  of  the  Manhattan  Eye,  Ear,  and  Throat  Hospital: 
J.  Edward  Giles,  M.  D.,  Surgeon  In  Eye  Department;  Arthur  B. 
Duel,  M.  D.,  (chairman).  Surgeon  in  Ear  Department;  HARMON 
Smith,  M.  D.,  Surgeon  in  Throat  Department.  Assisted  by  JOHN  R. 
Shannon,  M.  D.,  Assistant  Surgeon  in  E^e  Department;  and  John 
R.  Page,  M.  D.,  Assistant  Surgeon  in  Ear  Department.  With  chap- 
ters by  Herbert  B.  Wilcox,  M.  D.,  Attending  Physician  to  the  Hos- 
pital; and  Mils  Eugenia  D.  Ayers,  Superintendent  of  Nurses.  i2mo 
of  260  pages,  illustrated.  Cloth,  $1.50  net. 

Friedenwald  and  Ruhrah's  Dietetics 
ror    IN  urses  new  (2d)  edition 

This  work  has  been  prepared  to  meet  the  needs  of  the  nurse, 
both  in  training  school  and  after  graduation.  American  J ozir- 
nal  of  Nzirsing  says  it  "is  exactly  the  book  for  which  nurses 
and  others  have  long  and  .vainly  sought." 

Dietetics  for  Nurses.  By  Julius  Friedenwald,  M.  D.,  Professor 
of  Diseases  of  the  Stomach,  and  John  Ruhrah,  M.  D.,  Professor  of 
Diseases  of  Children,  College  of  Physicians  and  Surgeons,  Baltimore. 
i2mo  volume  of  395  pages.  Cloth,  $1.50  net 

Friedenwald  &  Ruhrah  on  Diet 

Diet  in  Health  and  Disease.  By  Julius  Frieden- 
WAi^D,  M.D.,  and  John  Ruhrah,  M.D.  Octavo  vol- 
ume of  764  pages.  Cloth,  $4.00  net. 

Galbraith's  Personal  Hygiene  and  Physical 
Training  for  Women  illustrated 

Personal  Hygiene  and  Physical  Training  for  Women.  By  Anna  M. 
Galbraith,  M.  D.,  Fellow  New  York  Academy  of  Medicine.  i2mo 
of  371  pages,  illustrated.  Cloth,  $2.00  net. 

Galbraith's  Four  Epochs  of  Woman's  Life 

THE  NEW  (2d)   EDITION 

The  Four  Epochs  of  Woman's  Life.  By  Anna  M.  Galbraith,  M.D. 
With  an  Introductory  Note  by  John  H.  Musser,  M.  D.,  University 
of  Pennsylvania,     izmo  of  247  pages.  Cloth,  $1.50  net. 


THIRD  EDITION 


McCombs'  Diseases  of  Children  for  Nurses 

NEW  (2d)   EDITION      . 

Dr.  McCombs'  experience  in  lecturing  to  nurses  has  enabled 
him  to  emphasize 7/^9^'  those  poi7its  thai  nurses  viost  need  to  know. 
National  Hospital  Record  says:  "We  have  needed  a  good 
book  on  children's  diseases  and  this  volume  admirably  fills 
the  want."  The  nurse's  side  has  been  written  by  head 
nurses,  very  valuable  being  the  work  of  Miss  Jennie  Manly. 

Diseases  of  Children  for  Nurses.  By  Robert  S.  McCoa\BS,  M.  D., 
Instructor  of  Nurses  at  the  Children's  Hospital  of  Philadelphia.  i2mo 
of  470  pages,  illustrated.  Cloth,-  $2.00  net 


NEW  (2d)   EDITION 


Wilson's  Obstetric  Nursing 

In  Dr.  Wilson's  work  the  entire  subject  is  covered  frcm  the 
beginning  of  pregnancy,  its  course,  signs,  labor,  its  actual 
accomplishment,  the  puerperium  and  care  of  the  infant. 
AiJierican  Journal  of  Obstetrics  says:  "  Every  page  empasizes 
the  nurse's  relation  to  the  case."    . 

A  Reference  Handbook  of  Obstetric  Nursing.  By  W.  Reynolds 
Wilson,  M.D.,  Visiting  Physician  to  the  Philadelphia  Lying-in  Char- 
ity.   32mo  of  355  pages,  illustrated.  Flexible  leather,  $1.25  net 

American  Pocket  Dictionary   new  (7th)  edition 

The  Trained  Nurse  and  Hospital  Review  says:  "We  have 
had  many  occasions  to  refer  to  this  dictionary,  and  in  every 
instance  we  have  found  the  desired  information." 

American  Pocket  Medical  Dictionary.  Edited  by  W.  A.  Newa\an 
DORLAND,  A.  M.,  M.  D.,  Loyola  University,  Chicago.  Flexible 
leather,  gold  edges,  $i.oo  net;  with  patent  thumb  index,   $1.25  net. 


SECOND 
EDITION 


Lewis'  Anatomy  and  Physiology 

Nurses  Joarnal  of  Pacific  Coast  sa3'S  "it  is  not  in  any  sense 
rudimentary,  but  comprehensive  in  its  treatment  of  the  sub- 
jects."    The  low  price  makes  this  book  particularly  attractive. 

Anatomy  and  Physiology  for  Nurses.  By  LeRoy  Lewis,  M.D.,  Lec- 
turer on  Anatomy  and  Physiology  for  Nurses,  Levyis  Hospital,  Bay 
City,  Mich.    i2mo  of  375  pages,  150  illustrations.       Cloth,  $1.7=;  net 


Bovd's  State  Registration  for  Nurses 


State 
uate  Cc 


Paul's  Materia  Medica  new  (z-u  edition 

Paul's  Fever  Nursing  new  (211  edition 

Hoxie  &  Laptad's  Medicine  for  Nurses 

JUST   READY-NEW  (2d)   EDITION,  REWRITTEN 

of  351  pages,  illustrated.  ^'"' 

t  SECOND 

Grafstrom's  Mechano-therapy  edition 

Nancrede's  Anatomy  new  (vtt,)  edhion 

Essentials  of  Anatomy.  ^haRles  B  G.  deNancRBDE    M^D    Unive^^ 
ity  of  Michigan.     i2mo,  400  pages,  i8o  illustrations,      v-iuu  ,  ,p 

Morrow's  Immediate  Care  of  Injured 
Register's  Fever  Nm'sing 

A  Text  Book  on  Practical  Fever  Nu -sing.  ^y.^^^Z^so^S^^ll- 
M.D.,  North  Carolina  Medical  ColU>ge.     Octavo  or  35°^^^  S^^;^^  ^^^^ 

trated. 

Pyle's  Personal  Hygiene        new  (sth)  edition 
Morris'  Materia  Medica         new  (7th)  edition 


Griffith's  Care  of  the  Baby     new  (s.h)  edition 


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